Hemoglobin during ribavirin-based HCV therapy is closely related to circulating levels of DHEA.
Ribavirin-induced anemia is the major side effect observed during HCV therapy. In an in vitro study, we recently discovered that DHEA can strongly inhibit this adverse event. We also evaluated a possible link between pre-treatment serum DHEA and hemoglobin during HCV therapy. Among the 108 patients of our cohort serum baseline DHEA levels were associated with hemoglobin levels at week 12 of treatment (r = 0.35; P = 0.0021). Patients with low baseline serum DHEA developed severe anemia. A serum level of DHEA less than 1,500 ng/ml had a sensitivity of 94.3% and a positive predictive value of 93.1% for the detection of hemoglobin less than 11 g/dl during the first 12 week of treatment. With pre-treatment DHEA levels below the cutoff, anemia was observed in 24.4% and 60.5% of patients treated with dual therapy and triple therapy, respectively, versus 0% and 15% of patients with higher DHEA levels. At week 12, the mean difference between patients with serum DHEA below and above the cutoff, in terms of absolute hemoglobin for dual and triple therapy groups were 1.2 and 1.7 g/dl, respectively (P = 0.005 and <0.001). Pretreatment DHEA levels are associated with hemoglobin levels during treatment. Based on these data, pretreatment assay of DHEA could be considered systematically in order to propose DHEA supplementation to potentiate the efficacy of the current and future use of ribavirin for HCV and HEV therapy. J. Med. Virol. 89:1033-1039, 2017. © 2016 Wiley Periodicals, Inc.
Department of Pharmacology, Amiens University Medical Center, Amiens, France.
Sandra
S
Bodeau
Department of Hepatogastroenterology, University Hospital, CHU, Amiens, France.
Jean-Philippe
JP
Lemouel
Department of Biostatistics, Amiens University Medical Center, Amiens, France.
Momar
M
Diouf
Department of Virology, Amiens University Medical Center, Amiens, France.|Virology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France.
Gilles
G
Duverlie
Department of Hepatogastroenterology, University Hospital, CHU, Amiens, France.
Eric
E
Nguyen-Khac
Department of Virology, Amiens University Medical Center, Amiens, France.|Virology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France.
Etienne
E
Brochot
D000328:Adult; D000368:Aged; D000740:Anemia / Q000139:chemically induced / Q000175:diagnosis*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003687:Dehydroepiandrosterone / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D055815:Young Adult
D000998:Antiviral Agents; D006454:Hemoglobins; D003687:Dehydroepiandrosterone; D012254:Ribavirin
Hepatitis C virus; antiviral agents; disease control; hepatitis E virus; toxicity; virus classification