Impact of ITPA Genetic Polymorphisms on Anemia in Egyptian Patients with Chronic Hepatitis C during Treatment with Peg-Interferon and Ribavirin
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- Category: Vol. 85, March 2017
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Impact of ITPA Genetic Polymorphisms on Anemia in Egyptian Patients with Chronic Hepatitis C during Treatment with Peg-Interferon and Ribavirin, MOHAMAD M. AL-SADEK ATTA, MOHAMAD ABD EL-HAMID MOHAMAD, ENTESAR H. EL-SHARKAWY, EBADA MOHAMAD SAID and MAHMOUD RAMADAN MAHMOUD
Abstract
Background: In Egypt, the prevalence of Hepatitis C Virus infection (HCV) is high (about 20%). Chronic HCV (CHC) is a slowly progressive disease complicated by liver cirrhosis, hepatic decompensation and hepatocellular carcino-ma. Treatment of CHC by pegylated Interferon-a (IFN)/ Ribavirin (RBV) combination therapy was Standard of Care (SoC) therapy till 2014. Regimens with new Direct Acting Antiviral drugs (DAAs) have high curative rates and minimal side effects. Ribavirin is directly toxic to erythrocytes and is associated with hemolysis which is reversible and dose related.
Aim of the work is to assess the role of Inosine Triphos-phatase (ITPA) Single Nucleotide Polymorphism (SNP) (rs1127354) in predicting RBV-induced anemia among Egyp-tian patients with CHC infection.
Patients and Methods: (90) nighty CHC Egyptian patients who had received standard care combination therapy with peg-IFN/RBV were enrolled in this study, Single Nucleotide Polymorphism (SNP) at ITPA (rs1127354) was genotyped by real time detection polymerase chain reaction.
Results: In the total 90 patients ITPase activity was normal among 81 (90%) CC; 9 (10%) patients had ITPase deficiency non CC group (6 CA +3 AA). Hb level between CC and non CC groups were highly significant different at week 4, 6, 8, 10, 12. And also from 16-24 week. Hb decline was significantly more among CC than non CC group of treatment. The RBV dose adjustment was higher in CC than non CC group. Platelets and thrombocytopenia decline was highly significant lower in CC group than non CC group from 4th week to 24th week of treatment.
Conclusion: ITPA polymorphism (rs1127354) was asso-ciated with RBV-induced anemia during peg-IFN and RBV therapy in CHC Egyptian patients.