Predictive factors of anemia during sofosbuvir and ribavirin therapy for genotype 2 chronic hepatitis C patients

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‐ef...

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Published in:Hepatology research 2019-08, Vol.49 (8), p.853-859
Main 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
Format: Article
Language:English
Subjects:
Anemia
Antiviral agents
Chronic infection
Epidermal growth factor receptors
estimated glomerular filtration rate
Genotype & phenotype
Genotypes
Glomerular filtration rate
Hemoglobin
Hemolytic anemia
Hepatitis
Hepatitis C
hepatitis C virus
inosine triphosphatase
Interferon
Multivariate analysis
Ribavirin
Triphosphatase
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Summary: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 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.
ISSN:1386-6346
1872-034X
DOI:10.1111/hepr.13354