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Hepatitis C and neutropenia

Sheehan, Vivien A.a; Weir, Alvab; Waters, Bradfordc

Current Opinion in Hematology: January 2014 - Volume 21 - Issue 1 - p 58–63
doi: 10.1097/MOH.0000000000000006
MYELOID BIOLOGY: Edited by David C. Dale

Purpose of review This review describes the pathogenesis and therapeutic implications of neutropenia in patients with hepatitis C.

Recent findings 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.

Summary 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:

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