Valuable antiviral therapeutic options for the treatment of chronic hepatitis C patients with thrombocytopenia

Eiichi Ogawa, Norihiro Furusyo, Murata Masayuki, H. Ikezaki, T. Ihara, T. Hayashi, Kazuhiro Toyoda, K. Okada, Mosaburo Kainuma, E. Kajiwara, K. Takahashi, T. Satoh, J. Hayashi

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Abstract

Thrombocytopenia in patients with chronic hepatitis C may represent an obstacle for the initiation of antiviral treatment. The aim of this study was to evaluate factors predictive of successful pegylated interferon (PEG-IFN) α2b and ribavirin (RBV) treatment for patients with thrombocytopenia with no history of splenectomy or partial splenic embolization. One hundred and fifty-one chronic hepatitis C patients (genotype 1: n = 110, genotype 2: n = 41) with TCP (<100 × 109/L) at baseline were enrolled. Pretreatment variables included interleukin 28B (IL28B) genotype (rs8099917) and homoeostasis model assessment of insulin resistance score (HOMA-IR). The kinetics of haemoglobin and platelets according to the inosine triphosphatase (ITPA) genotype (rs1127354) were investigated. Sustained virological response (SVR) was significantly more frequent in hepatitis C virus (HCV) genotype 2 (65.9%) than in genotype 1 (34.5%) patients (P < 0.0001). Multiple logistic regression analysis of HCV genotype 1 extracted IL28B TT genotype [odds ratio (OR) 5.97, P = 0.006] and HOMA-IR <2.5 (OR 7.14, P = 0.0016) as significant independent pretreatment predictors of SVR. The analyses of HCV genotype 2 showed that HOMA-IR was significantly related to SVR, but IL28B genotype was not. Patients with ITPA CC genotype showed a significant haemoglobin reduction and lower degree of platelets decrease than those with ITPA CA/AA genotypes. The most common reason for premature discontinuation of treatment was the development of hepatocellular carcinoma (n = 8, 5.3%). In conclusion, HOMA-IR is a useful predictor of SVR for patients with thrombocytopenia infected with HCV genotype 1 or 2 treated with PEG-IFNα2b and RBV. The inclusion of IL28B, ITPA genotypes and HOMA-IR adds valuable therapeutic information.

Original languageEnglish
Pages (from-to)838-846
Number of pages9
JournalJournal of Viral Hepatitis
Volume20
Issue number12
DOIs
Publication statusPublished - Dec 1 2013

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Chronic Hepatitis C
Thrombocytopenia
Antiviral Agents
Genotype
Insulin Resistance
Homeostasis
Hepacivirus
Therapeutics
Interleukins
Ribavirin
Hemoglobins
Blood Platelets
Odds Ratio
Splenectomy
Interleukin-1
Interferons
Hepatocellular Carcinoma
Logistic Models

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this

Valuable antiviral therapeutic options for the treatment of chronic hepatitis C patients with thrombocytopenia. / Ogawa, Eiichi; Furusyo, Norihiro; Masayuki, Murata; Ikezaki, H.; Ihara, T.; Hayashi, T.; Toyoda, Kazuhiro; Okada, K.; Kainuma, Mosaburo; Kajiwara, E.; Takahashi, K.; Satoh, T.; Hayashi, J.

In: Journal of Viral Hepatitis, Vol. 20, No. 12, 01.12.2013, p. 838-846.

Research output: Contribution to journalArticle

Ogawa, E, Furusyo, N, Masayuki, M, Ikezaki, H, Ihara, T, Hayashi, T, Toyoda, K, Okada, K, Kainuma, M, Kajiwara, E, Takahashi, K, Satoh, T & Hayashi, J 2013, 'Valuable antiviral therapeutic options for the treatment of chronic hepatitis C patients with thrombocytopenia', Journal of Viral Hepatitis, vol. 20, no. 12, pp. 838-846. https://doi.org/10.1111/jvh.12109
Ogawa, Eiichi ; Furusyo, Norihiro ; Masayuki, Murata ; Ikezaki, H. ; Ihara, T. ; Hayashi, T. ; Toyoda, Kazuhiro ; Okada, K. ; Kainuma, Mosaburo ; Kajiwara, E. ; Takahashi, K. ; Satoh, T. ; Hayashi, J. / Valuable antiviral therapeutic options for the treatment of chronic hepatitis C patients with thrombocytopenia. In: Journal of Viral Hepatitis. 2013 ; Vol. 20, No. 12. pp. 838-846.
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abstract = "Thrombocytopenia in patients with chronic hepatitis C may represent an obstacle for the initiation of antiviral treatment. The aim of this study was to evaluate factors predictive of successful pegylated interferon (PEG-IFN) α2b and ribavirin (RBV) treatment for patients with thrombocytopenia with no history of splenectomy or partial splenic embolization. One hundred and fifty-one chronic hepatitis C patients (genotype 1: n = 110, genotype 2: n = 41) with TCP (<100 × 109/L) at baseline were enrolled. Pretreatment variables included interleukin 28B (IL28B) genotype (rs8099917) and homoeostasis model assessment of insulin resistance score (HOMA-IR). The kinetics of haemoglobin and platelets according to the inosine triphosphatase (ITPA) genotype (rs1127354) were investigated. Sustained virological response (SVR) was significantly more frequent in hepatitis C virus (HCV) genotype 2 (65.9{\%}) than in genotype 1 (34.5{\%}) patients (P < 0.0001). Multiple logistic regression analysis of HCV genotype 1 extracted IL28B TT genotype [odds ratio (OR) 5.97, P = 0.006] and HOMA-IR <2.5 (OR 7.14, P = 0.0016) as significant independent pretreatment predictors of SVR. The analyses of HCV genotype 2 showed that HOMA-IR was significantly related to SVR, but IL28B genotype was not. Patients with ITPA CC genotype showed a significant haemoglobin reduction and lower degree of platelets decrease than those with ITPA CA/AA genotypes. The most common reason for premature discontinuation of treatment was the development of hepatocellular carcinoma (n = 8, 5.3{\%}). In conclusion, HOMA-IR is a useful predictor of SVR for patients with thrombocytopenia infected with HCV genotype 1 or 2 treated with PEG-IFNα2b and RBV. The inclusion of IL28B, ITPA genotypes and HOMA-IR adds valuable therapeutic information.",
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AU - Hayashi, T.

AU - Toyoda, Kazuhiro

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