title: Impact of ITPA gene polymorphisms on the risk of ribavirin-induced haemolytic anaemia using interferon-free antivirals for chronic hepatitis C.
abstract: BACKGROUND
  Single nucleotide polymorphisms (SNPs) at the ITPA gene are associated with haemolytic anaemia in chronic hepatitis C patients treated with pegylated interferon-ribavirin (RBV). Information in patients treated with interferon-free, direct-acting antivirals (DAA) is scarce.
  
  
  METHODS
  Median haemoglobin (Hb) levels were compared at baseline and at week 4, when ribavirin concentration achieves steady state, in all consecutive chronic hepatitis C patients treated with oral DAA plus RBV at our clinic.
  
  
  RESULTS
  Median Hb drop in 55 patients was greater in rs1127354-CC than -CA/AA (1.8 versus 0.7 g/dl; P=0.029), and in rs6051702-AA than -AC/CC carriers (2.2 versus 1.1 g/dl; P=0.016). Eleven (20%) patients experienced severe anaemia, defined as Hb drop >3 g/dl or to <10 g/dl. All of them were rs6051702-AA.
  
  
  CONCLUSIONS
  Baseline testing of rs6051702 may identify the subset of patients at greatest risk for RBV-induced anaemia using interferon-free hepatitis C therapies.
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.|Infectious Diseases Unit, La Paz University Hospital & IdiPAZ, Madrid, Spain.
authors.forename: Isabella
authors.initials: I
authors.lastname: Esposito
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Benítez-Gutiérrez
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Treviño
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Arias
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Maria Jesus
authors.initials: MJ
authors.lastname: Citores
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Requena
authors.affiliation: Infectious Diseases Unit, La Paz University Hospital & IdiPAZ, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Soriano
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Valentín
authors.initials: V
authors.lastname: Cuervas-Mons
authors.affiliation: Department of Internal Medicine & Liver Transplantation Unit, Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: de Mendoza
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D000743:Anemia, Hemolytic / Q000209:etiology*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004198:Disease Susceptibility; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011755:Pyrophosphatases / Q000235:genetics*; D012189:Retrospective Studies; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D000097630:Inosine Triphosphatase
chemical_list: D000998:Antiviral Agents; D011755:Pyrophosphatases; D012254:Ribavirin; C511829:ITPA protein, human; D000097630:Inosine Triphosphatase