The Relation between Inosine Triphosphatase Gene Variants and Anemia and Thrombocytopenia Induced by Combined Pegylated Interferon-Alfa and Ribavirin Therapy among Chronic Hepatitis C Patients in Egypt

Background and Aims: Hematological abnormalities during Hepatitis C Virus (HCV) combination therapy with pegylated interferon a and ribavirin often necessitate dose reduction. Variants of the ITPA gene have been reported to protect against anemia during the early stages of HCV combination treatments but have also been associated with larger decreases in platelet counts. We aimed to identify the association between specific ITPA gene polymorphisms and hematological abnormalities in patients undergoing HCV Combination therapy. Methods: In this prospective study, 149 patients treated with HCV combination therapy were enrolled at Ismailia Center for treatment of viral hepatitis during the period from May 2012 to December 2012. Single Nucleotide Polymorphisms (SNP) within the ITPA gene (rsll27354) was genotyped. We investigated the effect of ITPA gene variants on hematological abnormalities during the therapy. Results: The ITPArsll27354 minor variants was significantly associated with protection against anemia at week 4 (p=0.009) and with more severe decreases in platelet counts during HCV combination therapy. Conclusions: The ITPA SNP rsll27354 is a useful predictor of ribavirin induced anemia in Egyptian patients and may be related to more severe decreases in platelet counts during the early stage of HCV combination therapy.