Limited utility of ITPA deficiency to predict early anemia in HCV patients with advanced fibrosis receiving Telaprevir.

摘要: Background Severe anemia is a common side effect of Pegylated Interferon + Ribavirin (PR) and Telaprevir (TVR) in hepatitis C virus (HCV) genotype 1 patients with advanced fibrosis or cirrhosis (F3–F4). Inosine triphosphatase (ITPA) genetic variants are associated RBV- induced dose reduction. Aim To test the association ITPA polymorphisms rs1127354 rs7270101 hemoglobin (Hb) decline, need for RBV reduction (RBV DR), erythropoietin (EPO) support blood transfusions during first 12 weeks TVR triple therapy. Materials Methods 69 consecutive HCV-1 (mean age 57 years) F3-F4 who received PR were genotyped rs7270101. Estimated deficiency was graded on severity (0–3, no deficiency/mild/moderate/severe). Results ITPA absent 48 (70%), mild (17%) moderate 9 (13%). Mean week 4 Hb decline higher non deficient (3,85 g/dL) than mildly moderately (3,07 g/dL 1,67 g/dL, p<0.0001). Grade 3–4 developed 81% versus 67% 55% (p = ns). not RbvDR (no deficiency: 60%, mild: 58%, moderate: 67%; p ns), EPO use 65%, moderate:56%; ns) transfusion 27%, 17%, 33%; ns). Conclusions In F3–F4 chronic receiving based therapy, does impact management early anemia.