is ribavirin harmful?
Treatment for chronic hepatitis C is based on combination therapy with pegylated interferon and ribavirin (RBV).1,2 One of the most important side effects of RBV is hemolytic anemia, which may require RBV dose reduction or discontinuation3 with a significant decrease in the rate of sustained virologic response (SVR).4 Little is known about the safety of RBV treatment in patients with concomitant glucose-6-phosphate dehydrogenase (G6PD) deficiency, who are inherently prone to hemolysis.5 We prospectively studied changes in hemoglobin (Hb) levels in 112 patients with chronic hepatitis C, associated or not with G6PD deficiency, during and after combination therapy. G6PD activity was tested by a spectrophotometric method.6,7 Twenty-six (23.2%) patients (6 women, 20 men) had G6PD deficiency; 4 (3.6%) women had partial G6PD deficiency. Peginterferon alfa-2a or alfa-2b were administered subcutaneously once weekly at 180 µg and 1.5 µg/kg, respectively; RBV was administered orally daily at 800
