441 the Itpa Genotype Correlates With Hemolytic Anemia and Outcome After Treatment With Pegylated-Interferon and Ribavirin in Genotype Ib Chronic Hepatitis C

Kurosaki, Mami; Tanaka, Katsuaki; Suzuki, Yuhei; Hoshioka, Y.; Tamaki, Nobuharu; Kato, Takehito; Yasui, Y.; Hosokawa, Takanori; Ueda, Ken; Tsuchiya, Kunihiko; Kuzuya, Teiji; Nakanishi, Hiroyuki; Itakura, J.; Takahashi, Yusuke; Asahina, Y.; Mizokami, Masashi; Tanaka, Yoshito; Sakamoto, Naoya; Enomoto, N; Izumi, N.

doi:10.1016/s0168-8278(11)60443-1

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“…1). Recent retrospective analysis have suggested that patients with ITPA AA/CA genotypes have higher rates of receiving >80% of expected ribavirin dose and of SVR [47]. The utilization of ITPA gene variants in clinical practice needs to be further validated prospectively.…”

Section: Genetic Variants and Ribavirin-induced Anemiamentioning

confidence: 99%

Ribavirin: How Does it Work and is it Still Needed?

Bunchorntavakul

Reddy

2011

Curr Hepatitis Rep

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Ribavirin is a synthetic guanosine analogue, which acts against hepatitis C virus (HCV) through several mechanisms that include 1) immune modulation; 2) inhibition of inosine monophosphate dehydrogenase 3) inhibition of RNA-dependent RNA polymerase; 4) induction of HCV mutagenesis; and 5) modulation of interferonstimulated gene expression. Addition of ribavirin to peginterferon-α substantially improves sustained virologic response (SVR) and decreases relapse rates. Ribavirin can be associated with hemolytic anemia. However, recent data suggest that SVR is not negatively impacted by treatmentinduce anemia. Notably, optimal dosing strategy and the proper management of anemia are crucial to achieve the best treatment outcome. Several advances have been made in the areas relevant to ribavirin, such as the discovery of inosine triphosphatase gene as a promising pharmacogenetic marker and a predictor of anemia, and the role for erythropoiesis-stimulating agent in the management of anemia related to ribavirin use. Recent observations indicate that ribavirin will remain as a critical component of HCV therapy, even in the context of direct acting antivirals.

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Section: Genetic Variants and Ribavirin-induced Anemiamentioning

confidence: 99%