Pharmacogenetics of Ribavirin-Induced Anemia in Hcv Patients

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.

Keywords::

• chronic hepatitis C
• direct-acting antivirals
• dual therapy
• HCV
• hemolytic anemia
• ITPA
• pharmacogenomics
• SNP
• therapeutic drug monitoring
• vitamin D

Disclaimer

#UNI EN ISO 9001:2008 Certificate Laboratory; Certificate No. IT-64386; Certification for: ‘DESIGN, DEVELOPMENT AND APPLICATION OF DETERMINATION METHODS FOR ANTI-INFECTIVE DRUGS. PHARMACOGENETIC ANALYSIS’. www.tdm-torino.org

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.