Viral Hepatitis

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Management and Treatment of Hepatitis C Viral Infection: Table 8

for Health Care Providers

Back to Monitoring Treatment Safety and Efficacy

LABORATORY VALUESMANUFACTURER PACKAGE INSERT RECOMMENDATIONS

ANC = absolute neutrophil count; WBC = white blood cell counts

*If dose is maintained outside of manufacturer recommendations, monitor ANC more frequently and counsel patient on neutropenic precautions. In cirrhotic, post-liver transplantation or HIV/HCV coinfected patients who remain neutropenic despite dose reduction, consider starting GCSF until resolution.

†If dose is maintained outside of manufacturer recommendations, monitor platelet counts more frequently and for signs and symptoms of unusual bleeding or bruising.

WBC
<1.5 x 109/LReduce peginterferon alfa-2b dose by 50% and reevaluate
<1.0 x 109/LDiscontinue peginterferon alfa-2b until resolution
ANC*
<0.75 x 109/LPeginterferon alfa-2a: reduce dose to 135 mcg/wk and reevaluate
Peginterferon alfa-2b: reduce dose by 50% and reevaluate
<0.50 x 109/LDiscontinue peginterferon alfa until resolution
Platelets†
<80 k/mm3Peginterferon alfa-2b: reduce dose by 50% and reevaluate
<50 k/mm3Peginterferon alfa-2a: reduce dose to 90 mcg/wk and reevaluate
Peginterferon alfa-2b: discontinue until resolution
<25 k/mm3Peginterferon alfa-2a: discontinue until resolution