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Trinks J, Caputo M, Hulaniuk ML, Corach D, Flichman D. Hepatitis C virus pharmacogenomics in Latin American populations: implications in the era of direct-acting antivirals. Pharmgenomics Pers Med 2017; 10:79-91. [PMID: 28405170 PMCID: PMC5378445 DOI: 10.2147/pgpm.s125452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In recent years, great progress has been made in the field of new therapeutic options for hepatitis C virus (HCV) infection. The new direct-acting antiviral agents (DAAs) represent a great hope for millions of chronically infected individuals because their use may lead to excellent cure rates with fewer side effects. In Latin America, the high prevalence of HCV genotype 1 infection and the significant association of Native American ancestry with risk predictive single-nucleotide polymorphisms (SNPs) in IFNL4 and ITPA genes highlight the need to implement new treatment regimens in these populations. However, the universal accessibility to DAAs is still not a reality in the region as their high cost is one of the major, although not the only, limiting factors for their broad implementation. Therefore, under these circumstances, could the assessment of host genetic markers be a useful tool to prioritize DAA treatment until global access to these new drugs can be achieved? This review will summarize the scientific evidences and the potential implications of HCV pharmacogenomics in this rapidly evolving era of anti-HCV drug development.
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Affiliation(s)
- Julieta Trinks
- Basic Science and Experimental Medicine Institute (ICBME), University Institute of the Italian Hospital of Buenos Aires
- Scientific and Technological National Research Council (CONICET)
| | - Mariela Caputo
- Scientific and Technological National Research Council (CONICET)
- Servicio de Huellas Digitales Genéticas, Facultad de Farmacia y Bioquímica
| | - María L Hulaniuk
- Basic Science and Experimental Medicine Institute (ICBME), University Institute of the Italian Hospital of Buenos Aires
| | - Daniel Corach
- Scientific and Technological National Research Council (CONICET)
- Servicio de Huellas Digitales Genéticas, Facultad de Farmacia y Bioquímica
| | - Diego Flichman
- Scientific and Technological National Research Council (CONICET)
- Cátedra de Virología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
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Coppola N, De Pascalis S, Messina V, Di Caprio G, Martini S, de Stefano G, Starace M, Stornaiuolo G, Stanzione M, Ascione T, Minichini C, Sangiovanni V, Zampino R, Calò F, Rinaldi L, Persico M, Federico A, Buonomo AR, Borgia G, Gaeta GB, Filippini P, Gentile I. ITPase activity modulates the severity of anaemia in HCV-related cirrhosis treated with ribavirin-containing interferon-free regimens. Antivir Ther 2017; 22:551-558. [PMID: 28165327 DOI: 10.3851/imp3134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND To investigate the association between inosine triphosphatase (ITPase) activity and the degree of anaemia occurring during direct-acting antiviral (DAA)/ribavirin (RBV)-based therapy in patients with cirrhosis. METHODS In a multicentre, prospective study 227 patients with HCV-related cirrhosis treated with DAA and RBV were enrolled. All patients were screened for the rs1127354 and rs7270101 ITPA single nucleotide polymorphisms using direct sequencing. RESULTS 150 (66.1%) patients had normal (100%) ITPase activity, 48 (21.1%) had moderate (60%) activity and 29 (12.8%) minimal (≤30%) activity. The ITPase activity significantly influenced the haemoglobin concentration: at day 15 it was -1.248 (sd ±0.978) in the 150 patients with an ITPase activity of 100% and -0.616 (±0.862) in the 77 patients with an ITPase activity less than 100% (P<0.000), and at day 30 it was -1.941 ±1.218 versus -1.11 ±1.218 (P<0.000). The 63 patients with a severe (at least 3/dl) haemoglobin decline, compared to those without, more frequently had an ITPase activity of 100% (82.1% versus 62.8%; P=0.021), were older (mean age ±sd: 66.7 ±8.2 versus 61.4 ±9.7 years; P=0.004) and were treated with a higher ribavirin dose (13.7 ±2.1 versus 12.8 ±2.5 mg/kg/day; P=0.008). At multivariate logistic regression analysis, the ITPase activity of 100% (OR: 2.83; 95% CI: 1.12, 7.10), male gender (OR: 3.22; 95% CI: 1.35, 7.66), body mass index (OR: 1.17; 95% CI: 1.03, 1.34) and dose of ribavirin (OR: 1.22; 95% CI: 1.06, 1.47) were independent predictors of a severe decline in haemoglobin (P<0.0001). CONCLUSIONS This study suggests that the polymorphisms in the ITPA gene influence the severity of anaemia during the first month of a DAA/RBV-based treatment in HCV-related cirrhosis.
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Affiliation(s)
- Nicola Coppola
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Stefania De Pascalis
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | | | - Giovanni Di Caprio
- Infectious Diseases Unit, AO Caserta, Caserta, Italy
- HIV Unit, Second University of Naples, Naples, Italy
| | | | - Giorgio de Stefano
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Mario Starace
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Gianfranca Stornaiuolo
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Maria Stanzione
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Tiziana Ascione
- IX Interventional Ultrasound Unit for Infectious Diseases, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - Carmine Minichini
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | | | - Rosa Zampino
- Internal Medicine Unit, Department of Medical Science, Second University of Naples, Naples, Italy
| | - Federica Calò
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Luca Rinaldi
- Internal Medicine Unit, Department of Medical Science, Second University of Naples, Naples, Italy
| | | | | | | | | | - Giovanni Battista Gaeta
- Infectious Diseases Unit, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
| | | | - Ivan Gentile
- Infectious Diseases Unit, University Federico II, Naples, Italy
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D'Avolio A, Cusato J, De Nicolò A, Allegra S, Di Perri G. Pharmacogenetics of ribavirin-induced anemia in HCV patients. Pharmacogenomics 2016; 17:925-41. [PMID: 27248282 DOI: 10.2217/pgs.16.22] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Dual therapy (pegylated interferon plus ribavirin) was considered the standard of care for hepatitis C virus (HCV) treatment until 2011, when the first-wave direct-acting antivirals were added to this regimen for HCV genotype-1 patients to increase the sustained virological response rate. The second-wave direct-acting antivirals entered the clinical use also in some ribavirin (RBV)- and/or interferon-free combinations. Nevertheless, since some of the new therapeutic regimens also include RBV and its use results still associated with hemolytic anemia, this requires countermeasures to be prevented. These include the identification of several host predictive factors involved in RBV absorption, distribution, metabolism, elimination and many others that might influence this toxic effect. For this reason, we provided an overview of the potential role of pharmacogenomics in predisposing RBV-treated HCV patients to anemia.
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Affiliation(s)
- Antonio D'Avolio
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Jessica Cusato
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Amedeo De Nicolò
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Sarah Allegra
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
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Coppola N, Pisaturo M, Sagnelli C, Onorato L, Sagnelli E. Role of genetic polymorphisms in hepatitis C virus chronic infection. World J Clin Cases 2015; 3:807-822. [PMID: 26380828 PMCID: PMC4568530 DOI: 10.12998/wjcc.v3.i9.807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 12/09/2014] [Accepted: 06/08/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To analyze the host genetics factors influencing the clinical course and the response to antiviral treatment in patients with chronic hepatitis C (CHC).
METHODS: We conducted an electronic search on the PubMed and MEDLINE (2000-2014) databases and Cochrane library (2000-2014). A total of 73 articles were retrieved and their data were extensively evaluated and discussed by the authors and then analyzed in this review article.
RESULTS: Several studies associated polymorphisms in the interleukin 28B gene on chromosome 19 (19q13.13) with a spontaneous viral clearance in acute hepatitis C and with the response to pegylated interferon (Peg-IFN)-based treatment in chronic hepatitis C patients. Other investigations demonstrated that inosine triphosphate pyrophosphatase genetic variants protect hepatitis C virus-genotype-1 CHC patients from ribavirin-induced anemia, and other studies that a polymorphism in the patatin-like phospholipase domain-containing protein 3 was associated with hepatic steatosis in CHC patients. Although not conclusive, some investigations suggested that the vitamin D-associated polymorphisms play an important role in the achievement of sustained virologic response in CHC patients treated with Peg-IFN-based antiviral therapy. Several other polymorphisms have been investigated to ascertain their possible impact on the natural history and on the response to treatment in patients with CHC, but the data are preliminary and warrant confirmation.
CONCLUSION: Several genetic polymorphisms seem to influence the clinical course and the response to antiviral treatment in patients with CHC, suggesting individualized follow up and treatment strategies.
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Delvaux N, da Costa VD, da Costa MM, Villar LM, Coelho HSM, Esberard EBC, Flores PP, Brandão-Mello CE, Villela-Nogueira CA, de Almeida AJ, Lampe E. Inosine triphosphatase allele frequency and association with ribavirin-induced anaemia in Brazilian patients receiving antiviral therapy for chronic hepatitis C. Mem Inst Oswaldo Cruz 2015; 110:636-43. [PMID: 26154744 PMCID: PMC4569827 DOI: 10.1590/0074-02760150104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/08/2015] [Indexed: 12/19/2022] Open
Abstract
Inosine triphosphatase (ITPA) single nucleotide polymorphisms (SNPs) are strongly associated with protection against ribavirin (RBV)-induced anaemia in European, American and Asian patients; however, there is a paucity of data for Brazilian patients. The aim of this study was to evaluate the ITPA SNP (rs7270101/rs1127354) frequency in healthy and hepatitis C virus (HCV)-infected patients from Brazil and the association with the development of severe anaemia during antiviral therapy. ITPA SNPs were determined in 200 HCV infected patients and 100 healthy individuals by sequencing. Biochemical parameters and haemoglobin (Hb) levels were analysed in 97 patients who underwent antiviral therapy. A combination of AArs7270101+CCrs1127354 (100% ITPase activity) was observed in 236/300 individuals. Anaemia was observed in 87.5% and 86.2% of treated patients with AA (rs7270101) and CC genotypes (rs1127354), respectively. Men with AA (rs7270101) showed a considerable reduction in Hb at week 12 compared to those with AC/CC (p = 0.1475). In women, there was no influence of genotype (p = 0.5295). For rs1127354, men with the CC genotype also showed a sudden reduction in Hb compared to those with AC. Allelic distribution of rs7270101 and rs1127354 shows high rates of the genotypes AA and CC, respectively, suggesting that the study population had a great propensity for developing RBV-induced anaemia. A progressive Hb reduction during treatment was observed; however, this reduction was greater in men at week 12 than in women.
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Affiliation(s)
- Nathália Delvaux
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hepatites
Virais, Rio de Janeiro, RJ, Brasil
| | - Vanessa Duarte da Costa
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hepatites
Virais, Rio de Janeiro, RJ, Brasil
| | - Maristella Matos da Costa
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hepatites
Virais, Rio de Janeiro, RJ, Brasil
| | - Livia Melo Villar
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hepatites
Virais, Rio de Janeiro, RJ, Brasil
| | - Henrique Sérgio Moraes Coelho
- Universidade Federal do Rio de Janeiro, Hospital Universitário
Clementino Fraga Filho, Departamento de Hepatologia, Rio de Janeiro, RJ, Brasil
| | - Eliane Bordalo Cathalá Esberard
- Universidade Federal Fluminense, Hospital Universitário Antônio Pedro,
Departamento de Gastroenterologia, Rio de Janeiro, RJ, Brasil
| | - Priscila Pollo Flores
- Universidade Federal Fluminense, Hospital Universitário Antônio Pedro,
Departamento de Gastroenterologia, Rio de Janeiro, RJ, Brasil
| | - Carlos Eduardo Brandão-Mello
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário
Gaffrée e Guinle, Departamento de Medicina Geral, Rio de Janeiro, RJ, Brasil
| | - Cristiane Alves Villela-Nogueira
- Universidade Federal do Rio de Janeiro, Hospital Universitário
Clementino Fraga Filho, Departamento de Hepatologia, Rio de Janeiro, RJ, Brasil
| | - Adilson José de Almeida
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hepatites
Virais, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário
Gaffrée e Guinle, Departamento de Medicina Geral, Rio de Janeiro, RJ, Brasil
| | - Elisabeth Lampe
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hepatites
Virais, Rio de Janeiro, RJ, Brasil
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Tanaka T, Kurosaki M, Lilly LB, Izumi N, Sherman M. Identifying candidates with favorable prognosis following liver transplantation for hepatocellular carcinoma: Data mining analysis. J Surg Oncol 2015; 112:72-9. [PMID: 26032085 DOI: 10.1002/jso.23944] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/17/2015] [Accepted: 05/13/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The optimal cutoff of each value in configuring selection criteria for pre-transplant assessment of hepatocellular carcinoma (HCC) remains uncertain. METHODS To build a predictive model for recurrent HCC, we performed data mining analysis on patients who underwent LT for HCC at University Health Network (n = 246). The model was externally validated using a cohort from the Scientific Registry of Transplant Recipients (SRTR) database (n = 9,769). RESULTS Among 246 patients, 14.6% (n = 36) experienced recurrent HCC within 2.5 years post-LT. The risk prediction model for recurrent HCC identified two subgroups with low-risk (total tumor diameter [TTD] <4 cm and serum alpha-fetoprotein [AFP] <73 ng/ml, n = 135) and with high-risk (TTD >4 cm and/or AFP >73 ng/ml, n = 111). The reproducibility of the model was validated through the SRTR database; overall patient survival rate was significantly better in low-risk group than high-risk group (P < 0.0001). Using Cox regression model, this yardstick, not Milan criteria, was revealed to efficiently predict post-transplant survival independent of underlying characteristics (P < 0.0001). CONCLUSIONS Grouping LT candidates with pre-LT HCC by the cutoffs of TTD 4 cm and AFP 73 ng/ml which were unearthed by data mining analysis efficiently classify patients according by the post-transplant prognosis.
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Affiliation(s)
- Tomohiro Tanaka
- Multiorgan Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Division of Gastroenterology, University Health Netowrk, University of Toronto, Toronto, Ontario, Canada
| | - Masayuki Kurosaki
- Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
| | - Leslie B Lilly
- Multiorgan Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.,Division of Gastroenterology, University Health Netowrk, University of Toronto, Toronto, Ontario, Canada
| | - Namiki Izumi
- Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
| | - Morris Sherman
- Division of Gastroenterology, University Health Netowrk, University of Toronto, Toronto, Ontario, Canada
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Chen SH, Peng CY, Lai HC, Su WP, Lin CH, Li YF, Chuang PH, Chen CH. An index to predict ribavirin-induced anemia in asian patients with chronic genotype 1 hepatitis C. HEPATITIS MONTHLY 2015; 15:e27148. [PMID: 25834588 PMCID: PMC4377223 DOI: 10.5812/hepatmon.27148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 02/10/2015] [Accepted: 02/21/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Single-nucleotide polymorphisms (SNP) in the inosine triphosphate pyrophosphatase (ITPA) gene correlate with ribavirin (RBV)-induced anemia in patients with chronic hepatitis C (CHC) receiving combination therapy. Managing anemia is an early priority in the treatment process. OBJECTIVES The aim was to develop a predictive index based on ITPA SNP status to identify CHC patients at risk of anemia. PATIENTS AND METHODS A total of 418 eligible East Asian patients diagnosed with CHC genotype 1 (G1) received combination therapy in this study. Participant DNA was genotyped for a functional ITPA SNP (C/C, A/A or C/A) on chromosome 20 at rs1127354. A predictive index was constructed by incorporating independent factors identified for severe anemia events (hemoglobin < 10 g/dL). Areas under the receiver-operating characteristic curves (AUCs) represented the diagnostic accuracies of the predictive index in randomly assigned development and validation cohorts. RESULTS Multiple logistic regressions identified age (≥ 50 y: OR = 9.7, 95% CI = 5.0 - 18.6), ITPA rs1127354 (C/C: OR = 3.3, 95% CI = 1.8 - 5.8) and baseline hemoglobin (< 14.0 g/dL: OR 6.4, 95% CI = 3.3 - 12.1; 14.0 - 14.9: OR = 2.4, 95% CI = 1.2 - 4.6) as predictors of severe anemia throughout the treatment. For severe anemia, the predictive index incorporating age, ITPA SNP status and baseline hemoglobin yielded diagnostic accuracies (AUCs) of 0.830 (95% CI = 0.783 - 0.871) in the development (n = 324) and 0.902 (0.826 - 0.925) in the validation (n = 81) cohorts. CONCLUSIONS In patients with CHC G1 and receiving combination therapy, ITPA SNP-based index was an accurate and practical solution for prediction of severe anemia.
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Affiliation(s)
- Sheng-Hung Chen
- Institute of Clinical Medical Science, School of Medicine, China Medical University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Yuan Peng
- School of Medicine, China Medical University, Taichung, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Corresponding Author: Cheng-Yuan Peng, Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taiwan. Tel: +88-6422052121, E-mail:
| | - Hsueh-Chou Lai
- Institute of Clinical Medical Science, School of Medicine, China Medical University, Taichung, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Pang Su
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hsin Lin
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Fen Li
- Institute of Biostatistics, China Medical University, Taichung, Taiwan
| | - Po-Heng Chuang
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Hsiang Chen
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Gatselis NK, Zachou K, Saitis A, Samara M, Dalekos GN. Individualization of chronic hepatitis C treatment according to the host characteristics. World J Gastroenterol 2014; 20:2839-53. [PMID: 24659876 PMCID: PMC3961989 DOI: 10.3748/wjg.v20.i11.2839] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/19/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) infection is a global health problem that affects more than 170 million people worldwide. It is a major cause of cirrhosis and hepatocellular carcinoma, making the virus the most common cause of liver failure and transplantation. The standard-of-care treatment for chronic hepatitis C (CHC) has been changed during the last decade and direct acting antiviral drugs have already been used. Besides, understanding of the pathogenesis of CHC has evolved rapidly during the last years and now several host factors are known to affect the natural history and response to treatment. Recent genome-wide association studies have shown the important role of interleukin-28B and inosine triphosphatase in HCV infection. The present review article attempts to summarize the current knowledge on the role of host factors towards individualization of HCV treatment.
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D’Avolio A, De Nicolò A, Cusato J, Ciancio A, Boglione L, Strona S, Cariti G, Troshina G, Caviglia GP, Smedile A, Rizzetto M, Di Perri G. Association of ITPA polymorphisms rs6051702/rs1127354 instead of rs7270101/rs1127354 as predictor of ribavirin-associated anemia in chronic hepatitis C treated patients. Antiviral Res 2013; 100:114-9. [DOI: 10.1016/j.antiviral.2013.07.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/10/2013] [Accepted: 07/29/2013] [Indexed: 12/12/2022]
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