首页|Several factors including ITPA polymorphism influence ribavirin-induced anemia in chronic hepatitis C

Several factors including ITPA polymorphism influence ribavirin-induced anemia in chronic hepatitis C

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AIM:To construct formulae for predicting the likelihood of ribavirin-induced anemia in pegylated interferon α plus ribavirin for chronic hepatitis C.METHODS:Five hundred and sixty-one Japanese patients with hepatitis C virus genotype 1b who had received combination treatment were enrolled and assigned randomly to the derivation and confirmatory groups.Single nucleotide polymorphisms at or nearby ITPA were genotyped by real-time detection polymerase chain reaction.Factors influencing significant anemia (hemoglobin concentration ＜ 10.0 g/dL at week 4 of treatment) and significant hemoglobin decline (declining concentrations ＞ 3.0 g/dL at week 4) were analyzed using multiple regression analyses.Prediction formulae were constructed by significantly independent factors.RESULTS:Multivariate analysis for the derivation group identified four independent factors associated with significant hemoglobin decline:hemoglobin decline at week 2 [P =3.29 × 10-17,odds ratio (OR) =7.54(g/dL)],estimated glomerular filtration rate [P =2.16 × 10-4,OR =0.962 (mL/min/1.73 m2)],rs1127354 (P=5.75 x 10-4,OR =10.94) and baseline hemoglobin [P =7.86 x 10-4,OR =1.50 (g/dL)].Using the model constructed by these factors,positive and negative predictive values and predictive accuracy were 79.8％,88.8％ and 86.2％,respectively.For the confirmatory group,they were 83.3％,91.0％ and 88.3％.These factors were closely correlated with significant anemia.However,the model could not be constructed,because no patients with rs1127354 minor genotype CA/AA had significant anemia.CONCLUSION:Reliable formulae for predicting the likelihood of ribavirin-induced anemia were constructed.Such modeling may be useful in developing individual tailoring and optimization of ribavirin dosage.

Chronic hepatitis C virus infectionRibavirinPegylated interferon αPrediction modelHemolytic anemiaSingle nucleotide polymorphism

Akihito Tsubota、Noritomo Shimada、Hiroshi Abe、Kai Yoshizawa、Rie Agata、Yoko Yumoto、Makiko Ika

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Institute of Clinical Medicine and Research, The Jikei University School of Medicine, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, Japan

Division of Gastroenterology and Hepatology,Kashiwa Hospital, The Jikei University School of Medicine,163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, Japan

Department of Gastroenterology, Shinmatsudo Central General Hospital,1-380 Shinmatsudo, Matsudo, Chiba 270-0034, Japan

Division of Gastroenterology and Hepatology, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan

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2012

10.3748/wjg.v18.i41.5879

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(41)
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