Anemia and thrombocytosis induced by ribavirin monotherapy in patients with chronic hepatitis C
Journal of Gastroenterology, 04/18/2012Kobayashi T et al.
Ribavirin (RBV) monotherapy induced anemia and affected thrombocytosis in patients with chronic hepatitis C (CHC). Elevated endogenous erythropoietin (EPO) may stimulate platelet production.
Patients with CHC (n = 30) received RBV monotherapy for 4 weeks.
The RBV dose was determined on the basis of body weight.
Complete blood count, and serum erythropoietin (EPO) and thrombopoietin (TPO) levels were assessed.
The associations between these parameters and the ITPA SNP (rs1127354) were analyzed.
Over the 4 weeks, the median hemoglobin level of all patients decreased significantly, from 13.6 (10.5-16.6) to 11.7 (9.4-14.9) g/dl (P < 0.001), and the platelet counts increased, from 14.0 × 104 (8.9-37.4 × 104) to 15.8 × 104 (10.2-40.6 × 104) /mm3 (P = 0.003).
At week 4, hemoglobin levels differed between patients with the ITPA CC genotype and those with the AA or AC genotypes [11.1 (9.4-13.5) vs. 12.9 (12.5-14.9) g/dl, P = 0.001].
The platelet change ratio (i.e., platelet count at week 4/platelet count at baseline) in the patients with developing anemia was correlated with the increase in the serum EPO level over 4 weeks (r = 0.88, P = 0.002), but not with the increase in the serum TPO level over 4 weeks.
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