Predictive factors of anemia during sofosbuvir and ribavirin therapy for genotype 2 chronic hepatitis C patients. Issue 8 (23rd May 2019)

• Record Type: Journal Article
• Authors: Urabe, Ayako; Sakamori, Ryotaro; Tahata, Yuki; Yamada, Ryoko; Imai, Yasuharu; Hagiwara, Hideki; Tamura, Shinji; Fukui, Hiroyuki; Yamada, Yukinori; Kaneko, Akira; Hijioka, Taizo; Kodama, Takahiro; Hikita, Hayato; Tatsumi, Tomohide; Takehara, Tetsuo
• Is Part Of: Hepatology research. Volume 49:Issue 8(2019)
• Page Start: 853
• Page End: 859
• Publication Date: 2019-05-23
• Subjects: anemia -- estimated glomerular filtration rate -- hepatitis C virus -- inosine triphosphatase; Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.13354
• Languages: English
• ISSNs: 1386-6346

Abstract

Abstract : Aim: Sofosbuvir (SOF) and ribavirin (RBV) combination therapy has improved the sustained virologic response (SVR) rate and shortened the treatment duration for patients with chronic hepatitis C virus (HCV) genotype 2 infection. Ribavirin‐induced hemolytic anemia is one of the most troublesome side‐effects of SOF/RBV therapy; however, factors associated with this condition have not been fully elucidated. We aimed to identify a safer way to complete treatment with SOF/RBV therapy by examining factors related to RBV‐induced hemolytic anemia and identifying patients who did not develop anemia. Methods: Two hundred and one patients with genotype 2 chronic hepatitis C treated with SOF/RBV therapy were studied. Significant factors associated with the decline in hemoglobin (Hb) levels from the baseline were analyzed. Results: The SVR rate was 96.5% (194 out of 201 patients) based on intent‐to‐treat analysis. In multivariate analysis, inosine triphosphatase ( ITPA ) gene variation ( P < 0.0001) and estimated glomerular filtration rate (eGFR) (0.001) were significantly associated with a decrease in Hb levels less than 2 g/dL. All patients were divided into four groups by ITPA and eGFR at baseline, and we identified patients with ITPA CA/AA and eGFR >75 as a group that did not develop anemia. Conclusions: The results presented here suggest that patients with ITPA CA/AA and eGFR >75 had no reduction in Hb levels during the treatment with SOF/RBV in HCV genotype 2‐infected patients. Adding RBV to direct‐acting antiviral therapy might not be problematic in certain patients, at least in terms of the occurrence of anemia.