This review describes the pathogenesis and therapeutic implications of neutropenia in patients with hepatitis C.
Mild-to-moderate neutropenia is increasingly recognized as the hepatitis C population has caused increased cirrhosis. Multiple mechanisms for the neutropenia have been postulated, with recent evidence pointing toward a combination of hypersplenism, autoimmunity, and direct viral infection of bone marrow cells. Advances in antiviral therapy are associated with worsened neutropenia and dose modification. Severe neutropenia is underreported and is generally not associated with increased rates of infection.
Although neutropenia is common in hepatitis C patients it generally has a benign course and may not prohibit antiviral therapy.
aTexas Children's Hematology Center, Baylor College of Medicine, Houston, Texas
bDivision of Hematology-Oncology, Veterans Affairs Medical Center and University of Tennessee Health Science Center
cDivision of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Tennessee Health Science Center, Memphis, Tennessee, USA
Correspondence to Bradford Waters, MD, Medical Service (111), VA Medical Center, 1030 Jefferson Avenue, Memphis, TN 38104, USA. Tel: +1 901 523 8990 ext 6648; fax; 1 901 577 7286; e-mail: firstname.lastname@example.org