Evaluating Treatment of Hepatitis C Infection with Respect to Resulting Hemolytic Anemia

The combination therapy of antiviral peg-IFN and ribavirin (RBV) has evolved as one of the better treatments for Hepatitis-C (HCV). In spite of its success in controlling HCV infection, it has also been associated with treatment related adverse side-effects. The most common among them is hemolytic anemia caused by premature breakdown of hemoglobin in the red blood cell (RBC). More than 67% of treated chronic HCV patients show signs of acute anemia leading to dose reduction or even therapy cessation. This paper extends the basic mathematical model of Dahari et. al. and study the effect of combination therapy in light of anemia. In order to achieve this we introduce RBC and drug concentration in the model. Analysis of this model provides a quantification of the drug concentration that is tolerable by the body without succumbing to hemolytic anemia. This will provide an estimate of the increment in RBC production necessary to keep from hemolytic anemia and settle on a balanced HCV treatment.