Anemia and thrombocytosis induced by ribavirin monotherapy in patients with chronic hepatitis C

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• 作者：Tomoe Kobayashi (1)
  Shuhei Hige (1)
  Katsumi Terashita (1)
  Masato Nakai (1)
  Hiromasa Horimoto (1)
  Takuya Sho (1)
  Mitsuru Nakanishi (1)
  Koji Ogawa (2)
  Makoto Chuma (1)
  Naoya Sakamoto (3)
  Masahiro Asaka (4)
  
• 关键词：Ribavirin ; Anemia ; Erythropoietin ; Thrombocytosis ; ITPA SNP
• 刊名：Journal of Gastroenterology
• 出版年：2012
• 出版时间：November 2012
• 年：2012
• 卷：47
• 期：11
• 页码：1228-1237
• 全文大小：329KB
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• 作者单位：Tomoe Kobayashi (1)
  Shuhei Hige (1)
  Katsumi Terashita (1)
  Masato Nakai (1)
  Hiromasa Horimoto (1)
  Takuya Sho (1)
  Mitsuru Nakanishi (1)
  Koji Ogawa (2)
  Makoto Chuma (1)
  Naoya Sakamoto (3)
  Masahiro Asaka (4)
  
  1. Department of Gastroenterology, Hokkaido University Hospital, North 17 Jo, West 5 Cho-me, Kita-ku, Sapporo, 060-8638, Japan
  2. Department of Gastroenterology, Hakodate Municipal Hospital, 10-1 Minato-cho, Hakodate, 041-8680, Japan
  3. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
  4. Department of Cancer Preventive Medicine, Hokkaido University Graduate School of Medicine, North 12 Jo, West 7 Cho-me, Kita-ku, Sapporo, 060-0812, Japan
  
• ISSN：1435-5922

文摘

Background An inosine triphosphatase (ITPA) single-nucleotide polymorphism (SNP) is associated with anemia induced by pegylated interferon and ribavirin (RBV) combination therapy in patients with chronic hepatitis C (CHC). However, there are very few reports on the hematological effects of RBV monotherapy. Here, hematological changes were monitored in patients with CHC who received RBV monotherapy, and the mechanism of these changes was investigated. Methods Patients with CHC (n?=?30) received RBV monotherapy for 4?weeks. The RBV dose was determined on the basis of body weight. Complete blood count, and serum erythropoietin (EPO) and thrombopoietin (TPO) levels were assessed. The associations between these parameters and the ITPA SNP (rs1127354) were analyzed. Results Over the 4?weeks, the median hemoglobin level of all patients decreased significantly, from 13.6 (10.5-6.6) to 11.7 (9.4-4.9) g/dl (P?<?0.001), and the platelet counts increased, from 14.0?×?104 (8.9-7.4?×?104) to 15.8?×?104 (10.2-0.6?×?104) /mm3 (P?=?0.003). At week 4, hemoglobin levels differed between patients with the ITPA CC genotype and those with the AA or AC genotypes [11.1 (9.4-3.5) vs. 12.9 (12.5-4.9) g/dl, P?=?0.001]. The platelet change ratio (i.e., platelet count at week 4/platelet count at baseline) in the patients with developing anemia was correlated with the increase in the serum EPO level over 4?weeks (r?=?0.88, P?=?0.002), but not with the increase in the serum TPO level over 4?weeks. Conclusions RBV monotherapy induced anemia and affected thrombocytosis in patients with CHC. Elevated endogenous EPO may stimulate platelet production.