Genome-wide association study of interferon-related cytopenia in chronic hepatitis C patients.
Journal Article (Journal Article)
BACKGROUND & AIMS: Interferon-alfa (IFN)-related cytopenias are common and may be dose-limiting. We performed a genome wide association study on a well-characterized genotype 1 HCV cohort to identify genetic determinants of peginterferon-α (pegIFN)-related thrombocytopenia, neutropenia, and leukopenia. METHODS: 1604/3070 patients in the IDEAL study consented to genetic testing. Trial inclusion criteria included a platelet (Pl) count ≥80×10(9)/L and an absolute neutrophil count (ANC) ≥1500/mm(3). Samples were genotyped using the Illumina Human610-quad BeadChip. The primary analyses focused on the genetic determinants of quantitative change in cell counts (Pl, ANC, lymphocytes, monocytes, eosinophils, and basophils) at week 4 in patients >80% adherent to therapy (n=1294). RESULTS: 6 SNPs on chromosome 20 were positively associated with Pl reduction (top SNP rs965469, p=10(-10)). These tag SNPs are in high linkage disequilibrium with 2 functional variants in the ITPA gene, rs1127354 and rs7270101, that cause ITPase deficiency and protect against ribavirin (RBV)-induced hemolytic anemia (HA). rs1127354 and rs7270101 showed strong independent associations with Pl reduction (p=10(-12), p=10(-7)) and entirely explained the genome-wide significant associations. We believe this is an example of an indirect genetic association due to a reactive thrombocytosis to RBV-induced anemia: Hb decline was inversely correlated with Pl reduction (r=-0.28, p=10(-17)) and Hb change largely attenuated the association between the ITPA variants and Pl reduction in regression models. No common genetic variants were associated with pegIFN-induced neutropenia or leucopenia. CONCLUSIONS: Two ITPA variants were associated with thrombocytopenia; this was largely explained by a thrombocytotic response to RBV-induced HA attenuating IFN-related thrombocytopenia. No genetic determinants of pegIFN-induced neutropenia were identified.
Full Text
Duke Authors
Cited Authors
- Thompson, AJ; Clark, PJ; Singh, A; Ge, D; Fellay, J; Zhu, M; Zhu, Q; Urban, TJ; Patel, K; Tillmann, HL; Naggie, S; Afdhal, NH; Jacobson, IM; Esteban, R; Poordad, F; Lawitz, EJ; McCone, J; Shiffman, ML; Galler, GW; King, JW; Kwo, PY; Shianna, KV; Noviello, S; Pedicone, LD; Brass, CA; Albrecht, JK; Sulkowski, MS; Goldstein, DB; McHutchison, JG; Muir, AJ
Published Date
- February 2012
Published In
Volume / Issue
- 56 / 2
Start / End Page
- 313 - 319
PubMed ID
- 21703177
Pubmed Central ID
- PMC3634361
Electronic International Standard Serial Number (EISSN)
- 1600-0641
Digital Object Identifier (DOI)
- 10.1016/j.jhep.2011.04.021
Language
- eng
Conference Location
- Netherlands