Guillermo Cabrera Álvarez, Diana Gómez-Galicia, Lourdes Rodríguez-Fragoso, Vicente Madrid-Marina, Luis Cañedo Dorantes, Miguel Sánchez-Alemán, Nahum Méndez-Sánchez, Jorge Reyes-Esparza
Background. Thrombocytopenia is a common hematologic disorder observed in patients with chronic hepatitis C virus (HCV) infection. Combined peginterferon (PEG-INF) and ribavirin treatment may exacerbate thrombocytopenia in patients with HCV. Objective. The aim of this pilot clinical trial was to assess the efficacy, tolerability and safety of Danazol in thrombocytopenia associated with PEG-INF and ribavirin treatment in patients with HCV. Material and methods. We included patients whose platelets were < 90,000/mm3 and who were undergoing antiviral treatment. Danazol (300-600 mg/day) was administered during and until the end of antiviral therapy [7.6 months (2 to 11 months)]. The monitoring was performed through platelet analysis and liver function tests. A viral load test was done at the beginning and end of treatment. Fortynine patients receiving a combined therapy of PEG-INF, ribavirin and Danazol increased their platelet levels to 121,081/mm3 (46,000-216,000/mm3); 10.6% of patients gained > 100,000 platelets/mm3, and 71% of patients maintained their initial platelet levels. Sustained viral response (SVR) was achieved in 63% of patients. SVR rates were high in patients with genotype non 1 (78.7%) and decreased in patients with genotype 1 (60.1%). The increase in platelet levels was associated to an increase in fibrinogen levels and a decrease in the activity of ALT. By contrast, patients without SVR presented a delayed response to increased platelet levels and showed no significant improvement in liver function when they received Danazol. Conclusion. Danazol can be used along with PEG-INF and ribavirin to treat thrombocytopenia in patients with HCV.
Key words. Platelets, Antiviral therapy, Chronic hepatitis, Viral hepatitis, Sustained viral response