Rational Guide to the Use of Erythropoietin in the Treatment of HCV Infection

Abstract

Hepatitis C virus (HCV) infection is the leading reason for liver transplant in North America. Combination therapy with pegylated interferon and ribavirin (RBV) is the standard of care for treatment of HCV infection. Unfortunately, this combination can lead to anemia, occasionally severe enough to precipitate discontinuation of therapy. Given that sustained viral response (SVR) is dependent upon duration of exposure to maximal dosages, especially of RBV, both discontinuation and dose reduction in RBV can affect SVR. Recombinant human erythropoietin (EPO) is used for hematologic support in a number of other conditions resulting in anemia. EPO has been increasingly used in HCV treatment to maintain RBV doses and support the HCV treatment regimen. Significant evidence shows that EPO can be used to improve anemia and its symptoms, improve quality of life, and enable the maintenance of RBV dosages in patients experiencing anemia.