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Hepatol Res. 2014 Oct;44(10):E290-6. doi: 10.1111/hepr.12257. Epub 2013 Nov 21.

Adjuvant epoetin-β with peginterferon-α and ribavirin in Japanese ribavirin-intolerant relapsed patients with chronic hepatitis C genotype 2.

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Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan.


Erythropoietin is widely used in the USA and some other Western countries to maintain doses of ribavirin during peginterferon/ribavirin-based treatment for chronic hepatitis C virus (HCV) infection. However, the impact of erythropoietin on sustained virological response (SVR) is unclear. Here, we report the cases of three Japanese ribavirin-intolerant relapsed patients with HCV genotype 2 who achieved SVR from retreatment by adding erythropoietin. Three women aged 50, 64 and 68 years with chronic HCV genotype 2 received retreatment with peginterferon-α and ribavirin. During their prior therapy, HCV RNA became negative according to real-time polymerase chain reaction at weeks 4-8 in all three patients; however, the total dose of ribavirin was 18.1-30.6% lower than the planned dose, and HCV RNA relapsed post-treatment. At present, epoetin-β 24 000 IU was introduced at weeks 2 or 3 of dual-combination therapy, resulting in a less than 4.2% reduction in the total dose of ribavirin. HCV RNA became negative at weeks 4-8, and all patients achieved SVR. Until the next-generation antiviral treatments for HCV genotype 2 become available, the addition of erythropoietin to dual therapy can be a treatment of choice for ribavirin-intolerant relapsed patients.


anemia; chronic hepatitis C; epoetin; erythropoietin; hepatitis C virus; peginterferon; ribavirin


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