Predictive factors of anemia during sofosbuvir and ribavirin therapy for genotype 2 chronic hepatitis C patients

摘要

Aim Sofosbuvir (SOF) and ribavirin (RBV) combination therapy has improved the sustained virologic response (SVR) rate and shortened the treatment duration for patients with chronic hepatitis C virus (HCV) genotype 2 infection. Ribavirin‐induced hemolytic anemia is one of the most troublesome side‐effects of SOF/RBV therapy; however, factors associated with this condition have not been fully elucidated. We aimed to identify a safer way to complete treatment with SOF/RBV therapy by examining factors related to RBV‐induced hemolytic anemia and identifying patients who did not develop anemia. Methods Two hundred and one patients with genotype 2 chronic hepatitis C treated with SOF/RBV therapy were studied. Significant factors associated with the decline in hemoglobin (Hb) levels from the baseline were analyzed. Results The SVR rate was 96.5% (194 out of 201 patients) based on intent‐to‐treat analysis. In multivariate analysis, inosine triphosphatase ( ITPA ) gene variation ( P ??0.0001) and estimated glomerular filtration rate (eGFR) (0.001) were significantly associated with a decrease in Hb levels less than 2?g/dL. All patients were divided into four groups by ITPA and eGFR at baseline, and we identified patients with ITPA CA/AA and eGFR 75 as a group that did not develop anemia. Conclusions The results presented here suggest that patients with ITPA CA/AA and eGFR 75 had no reduction in Hb levels during the treatment with SOF/RBV in HCV genotype 2‐infected patients. Adding RBV to direct‐acting antiviral therapy might not be problematic in certain patients, at least in terms of the occurrence of anemia.