Increase in platelet count based on inosine triphosphatase genotype during interferon beta plus ribavirin combination therapy.
Increase in platelet count based on inosine triphosphatase genotype during interferon beta plus ribavirin combination therapy.
复制标题
在干扰素β加利巴韦林联合治疗期间，基于肌苷三磷酸酶基因型的血小板计数增加。
DOI：
10.1111/j.1440-1746.2012.07171.x
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Mizokami M.
中科院分区：
文献类型：
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作者：
Nomura H;Miyagi Y; Tanimoto H;Yamashita N;Ito K;Masaki N;Mizokami M.
背景和目的：在PEG IFN-α联合利巴韦林治疗期间，肌苷三磷酸酶（ITPA）基因型与利巴韦林诱导的贫血和PEG IFN-α诱导的血小板减少相关。天然IFN-β加利巴韦林治疗与治疗期间血小板计数增加相关。我们研究了天然IFN-β/利巴韦林治疗过程中血小板计数根据ITPA基因型的降低情况，以确定血小板计数低的患者是否适合这种联合治疗。方法：共187例慢性丙型肝炎患者接受PEG IFN-α/利巴韦林或天然IFN-β/利巴韦林治疗。结果：PEG IFN-α/利巴韦林治疗第1周血小板计数下降，第2周血小板计数上升，之后血小板计数逐渐下降。血小板计数下降，直至自然IFN-β/病毒唑治疗第4周，之后血小板计数增加。第8周后的血小板计数相对于治疗前的血小板计数更高。与ITPA-CA/AA基因型患者相比，ITPA-CC基因型患者在天然IFN-β/利巴韦林治疗期间血小板计数下降幅度较小;无论治疗前血小板计数如何，该治疗8周后的血小板计数均高于治疗前血小板计数。多因素Logistic回归分析显示，天然IFN-β/利巴韦林治疗是第8周血小板升高的唯一显著独立预测因子。结论：天然IFN-β/利巴韦林治疗对ITPA-CC基因型患者是安全的，即使其治疗前血小板计数较低。
Background and Aim:The inosine triphosphatase (ITPA) genotype is associated with ribavirin‐induced anemia and pegylated interferon α (PEG IFN‐α)‐induced platelet reduction during PEG IFN‐α plus ribavirin combination therapy. Natural IFN‐β plus ribavirin therapy is associated with increases in platelet counts during treatment. We investigated decreases in platelet counts according toITPAgenotype during natural IFN‐β/ribavirin therapy to determine if patients with low platelet counts were eligible for this combination therapy.Methods:A total of 187 patients with chronic hepatitis C received PEG IFN‐α/ribavirin or natural IFN‐β/ribavirin therapy. Decreases in platelet counts based onITPAgenotype were investigated during treatment through 24 weeks.Results:Platelet counts decreased during week 1 of PEG IFN‐α/ribavirin therapy, but increased during week 2, after which platelet counts decreased gradually. Platelet counts decreased until week 4 of natural IFN‐β/ribavirin therapy, after which platelet counts increased. Platelet counts after week 8 were higher relative to pretreatment platelet counts. Patients with theITPA‐CC genotype showed a smaller decrease in platelet counts during natural IFN‐β/ribavirin therapy than those with theITPA‐CA/AA genotype; platelet counts after week 8 of this therapy were higher than pretreatment platelet counts, regardless of pretreatment platelet counts. Multivariate logistic regression analyses showed that natural INF‐β/ribavirin therapy was the only significant independent predictor for an increase in platelets through week 8.Conclusion:Natural IFN‐β/ribavirin therapy is safe for patients with theITPA‐CC genotype, even if their pretreatment platelet counts are low.