Quarta-feira, 14 de Julho de 2004

ERITROPOETINA NO CONTROLE DA ANEMIA CAUSADA PELA RIBAVIRINA

O tratamento da hepatite C consegue sucesso quando seis meses após o final do tratamento o resultado do PCR mostra que o vírus se mantém indetectável, com o qual se obtém a resposta virológica sustentada. 98,3% dos pacientes que conseguem este resultado são considerados curados, pois a erradicação do vírus dá-se de forma permanente.


A ribavirina é de fundamental importância no tratamento da hepatite C, porém, a anemia que produz como efeito colateral é um dos maiores inconvenientes enfrentados pelos pacientes e o maior vilão do tratamento, já que é grande o número daqueles que o devem abandonar.


Em pacientes infectados com o genótipo 1 o percentual de sucesso ao tratamento é directamente relacionado com a dosagem de ribavirina. 51% dos pacientes que tomam entre 1.000 e 1.200 mg por dia conseguem a cura, contra somente 40% se recebem uma dosagem de 800 mg por dia. Porém, aqueles que tomam uma dosagem maior de ribavirina são os que apresentam uma maior anemia.


 Normalmente se recomenda uma redução na dosagem de ribavirina para tentar diminuir os efeitos da anemia, porém, esta redução pode resultar numa diminuição da possibilidade de sucesso no tratamento. Vários estudos recentemente apresentados mostram que a administração de eritropoetina, na dosagem de 40.000 UI uma vez por semana, quando o paciente atinge níveis de hemoglobina perto de 4,0 g/dl., consegue manter o tratamento dos pacientes sem necessidade de diminuir a dosagem de ribavirina, e com isto manter um maior índice de resposta ao tratamento.


O aumento da hemoglobina causada pela eritropoetina não só consegue manter o tratamento integral como também melhora a qualidade de vida do paciente. A eritropoetina é uma glicoproteína que estimula, na medula óssea, a divisão e a diferenciação dos progenitores das células vermelhas do sangue.


Em conclusão, escrevem os autores, “Anemia em pacientes tratados com interferon e ribavirina pode ser mantida de forma efectiva e segura com a administração semanal de eritropoetina sem necessidade de sacrificar a dosagem óptima de ribavirina. Referência: N Brau - Epoetin alfa treatment for acute anemia during interferon plus ribavirin combination therapy for chronic hepatitis C. Journal of Viral Hepatitis 11(3): 191-197. May 2004.


Carlos Varaldo


Grupo Otimismo


http://www.hepato.com

publicado por ValNeto às 12:42

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