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ISSN 2073-8137

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The clinical significance of endotoxemia associated with neutropenia during antiviral therapy of chronic viral hepatitis C and the ways of its pharmacological correction

[Original research] [Internal diseases]
Natalya Geyvandova; Alexandr Yagoda; Ekaterina Bondarenko;

The content of endotoxin in serum was deter-
mined in 101 patients with HCV. All patients were
received the combined antiviral treatment (AVT):
pegylated IFN-2α (Pegasys) was given to 83 pa-
tients, whereas 18 patients received short-acting
Before AVT, the total white blood cell count,
absolute neutrophil count and the initial content
of endotoxin were within normal limit. During AVT
grade 2 neutropenia developed in 62 patients
(54 Pegasys and 8 short-acting IFN-α). The
increase in the endotoxin level in blood was
registered in all patients with neutropenia from the
8th week. In patients with neutropenia the level of
serum endotoxin was significantly higher than in
patients without neutropenia. There was found an
inverse correlation between the level of endotoxin
and ANC. Filgrastim («Neupomax») was used in
28 patients with neutropenia <1.000/mm3. The
level of endotoxemia authentically was decreased
on the background of the appointment of filgrastim
(p<0.05) and also was improved patients’
health status on the Beck’s depression scale.
Filgrastim treatment maintained ANC not below
1.000–1.500/ mm3 and, thus, prevented the
necessity to reduce the dose of interferon.


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Keywords: chronic viral hepatitis C, neutrophils, endotoxin, antiviral therapy, granulocyte colony-stimulating factor

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy