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Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy.

Publication ,  Journal Article
Clark, PJ; Aghemo, A; Degasperi, E; Galmozzi, E; Urban, TJ; Vock, DM; Patel, K; Thompson, AJ; Rumi, MG; D'Ambrosio, R; Muir, AJ; Colombo, M
Published in: J Viral Hepat
December 2013

Anaemia frequently complicates peginterferon/ribavirin therapy for chronic hepatitis C infection. Better prediction of anaemia, ribavirin dose reduction or erythropoietin (EPO) need, may enhance patient management. Inosine triphosphatase (ITPA) genetic variants are associated with ribavirin-induced anaemia and dose reduction; however, their impact in real-life clinic patient cohorts remains to be defined. We studied 193 clinic patients with chronic hepatitis C infection of mixed viral genotype (genotype 1/4 n = 123, genotype 2/3, n = 70) treated with peginterferon/ribavirin. Patients were genotyped for ITPA polymorphisms rs1127354 and rs7270101 using Taqman primers. Hardy-Weinberg equilibrium was present. Estimated ITPA deficiency was graded on severity (0-3, no deficiency/mild/moderate/severe, n = 126/40/24/3, respectively). Multivariable models tested the association with anaemia at 4 weeks of treatment [including decline in haemoglobin (g/dL); haemoglobin <10 g/dL and haemoglobin decline >3 g/dL]; ribavirin dose reduction and EPO use and explored sustained viral response (SVR) to peginterferon/ribavirin. More severe ITPA deficiency was associated with less reduction in haemoglobin level (P <0.001; R(2) = 0.34), less ribavirin dose reduction (OR 0.42; (95% CI = 0.23-0.77); P = 0.005) and less EPO use [OR 0.53; (0.30-0.94); P = 0.029]. ITPA deficiency was associated with SVR [OR: 1.70; (1.02-2.83); P = 0.041] independently of clinical covariates (adjusted R(2) = 0.31). In this clinical cohort, ITPA deficiency helped predict the risk of on-treatment anaemia, ribavirin dose reduction, need for EPO support and was associated with SVR. For patients on HCV regimens including peginterferon/ribavirin, testing for ITPA deficiency may have clinical utility.

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Published In

J Viral Hepat

DOI

EISSN

1365-2893

Publication Date

December 2013

Volume

20

Issue

12

Start / End Page

858 / 866

Location

England

Related Subject Headings

  • Treatment Outcome
  • Ribavirin
  • Pyrophosphatases
  • Middle Aged
  • Metabolism, Inborn Errors
  • Male
  • Interferons
  • Humans
  • Hepatitis C, Chronic
  • Gastroenterology & Hepatology
 

Citation

APA
Chicago
ICMJE
MLA
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Clark, P. J., Aghemo, A., Degasperi, E., Galmozzi, E., Urban, T. J., Vock, D. M., … Colombo, M. (2013). Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy. J Viral Hepat, 20(12), 858–866. https://doi.org/10.1111/jvh.12113
Clark, P. J., A. Aghemo, E. Degasperi, E. Galmozzi, T. J. Urban, D. M. Vock, K. Patel, et al. “Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy.J Viral Hepat 20, no. 12 (December 2013): 858–66. https://doi.org/10.1111/jvh.12113.
Clark PJ, Aghemo A, Degasperi E, Galmozzi E, Urban TJ, Vock DM, et al. Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy. J Viral Hepat. 2013 Dec;20(12):858–66.
Clark, P. J., et al. “Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy.J Viral Hepat, vol. 20, no. 12, Dec. 2013, pp. 858–66. Pubmed, doi:10.1111/jvh.12113.
Clark PJ, Aghemo A, Degasperi E, Galmozzi E, Urban TJ, Vock DM, Patel K, Thompson AJ, Rumi MG, D’Ambrosio R, Muir AJ, Colombo M. Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy. J Viral Hepat. 2013 Dec;20(12):858–866.
Journal cover image

Published In

J Viral Hepat

DOI

EISSN

1365-2893

Publication Date

December 2013

Volume

20

Issue

12

Start / End Page

858 / 866

Location

England

Related Subject Headings

  • Treatment Outcome
  • Ribavirin
  • Pyrophosphatases
  • Middle Aged
  • Metabolism, Inborn Errors
  • Male
  • Interferons
  • Humans
  • Hepatitis C, Chronic
  • Gastroenterology & Hepatology