title: Pharmacological exposure to ribavirin: a key player in the complex network of factors implicated in virological response and anaemia in hepatitis C treatment.
abstract: Ribavirin remains today a pivotal drug in the treatment of hepatitis C; in standard double therapy, as well as in triple combination with direct antiviral agents, ribavirin reduces relapse and can double the sustained virological response obtained with peginterferon alone or in association with direct antiviral agents. In the complex network of interacting factors determining sustained virological response independently of known predictive factors related to host and virus, two modern tools are emerging: polymorphisms in the IL28B gene and very early exposure to ribavirin. The use of a pharmacokinetic-pharmacodynamic model of early ribavirin exposure to adjust the dose individually would help promote a safer ribavirin use and improve sustained virological response. The variability of the influence of ribavirin exposure on anaemia is probably genetically determined; however, the low prevalence of the implicated protective alleles of the inosine triphosphate pyrophosphatase gene could explain their lack of influence on sustained virological response.
authors: Federation d'Hépatologie, CHU de Limoges, Limoges, France. veronique.loustaud-ratti@unilim.fr
authors: Véronique
authors: V
authors: Loustaud-Ratti
authors: Paul
authors: P
authors: Carrier
authors: Annick
authors: A
authors: Rousseau
authors: Marianne
authors: M
authors: Maynard
authors: Gérard
authors: G
authors: Babany
authors: Sophie
authors: S
authors: Alain
authors: Christian
authors: C
authors: Trépo
authors: Victor
authors: V
authors: De Ledinghen
authors: Marc
authors: M
authors: Bourlière
authors: Stanislas
authors: S
authors: Pol
authors: Vincent
authors: V
authors: Di Martino
authors: Jean-Pierre
authors: JP
authors: Zarski
authors: Alexandrina
authors: A
authors: Pinta
authors: Denis
authors: D
authors: Sautereau
authors: Pierre
authors: P
authors: Marquet