Induced anemia

RBV induced anemia can precipitate occult coronary artery disease, especially in older http://activerain.trulia.com/profile/korvin   patients (due to age related reduction in creatinine clearance).

 An accurate estimation of the glomerular filtration rate and the administration of a lower dose of RBV are recommendable in elderly patients.

 Neutropenia http://fontstruct.com/fontstructors/korvin/profile (with absolute neutrophil count ANC less than 1.

5 x109mL) and thrombocytopenia (less than 50 000 cellsmm3) are also common.

 Consequently, eligibility for treatment may be restricted in patients with advanced liver cirrhosis.

 The following decision tree is recommended for the management of neutropenia and thrombocytopenia: PegIFN dose reduction, when ANC 750 cellsmm3 and http://howtotreat.virb.com/ platelets count 50,000 cellsmm3; treatment discontinuation, when ANC 500 cellsmm3 and platelets count 25,000 cellsmm3.

 If neutrophils or platelets Antiviral Therapy: The Basics 23 counts go up, treatment can be restarted, but at a reduced Peg IFN dose; use of stimulating factors (i.

e.

 Filgastrim™ granulocyte macrophage colony stimulating factor or Eltrombopag™ an oral thrombopoietin receptor agonist) is not routinely recommended in clinical practice, except for patients with cirrhosis.

 Neuropsychiatric symptoms such as depression, irritability, insomnia, and, occasionally,http://www.myfolio.com/Korvin aggressive behavior are some of the most debilitating AEs of PegIFN therapy, occurring in approximately 20% to 30% of patients after the first month of treatment.

 Interventions may require an initial dose reduction, followed by permanent discontinuation of IFN in the case of persistently severe or worsening symptoms.

 In most cases, the neuropsychiatric symptoms resolve after PegIFN discontinuation.