Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin
Background/Purpose: The major dose-limiting toxicity of ribavirin is hemolytic anemia. We investigated the incidence, risk factors and impact on virological response of anemia in chronic hepatitis C genotype 2 patients receiving sofosbuvir plus ribavirin therapy. Methods: This was a retrospective re...
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Format: | Article |
Language: | English |
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Elsevier
2020-01-01
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Series: | Journal of the Formosan Medical Association |
Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664619304139 |
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doaj-13086ad5913a4056b336bce10fbc35cb |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chi-Ching Chen Shui-Yi Tung Kuo-Liang Wei Chien-Heng Shen Te-Sheng Chang Wei-Ming Chen Huang-Wei Xu Chih-Wei Yen Yi-Hsing Chen Sheng-Nan Lu Chao-Hung Hung |
spellingShingle |
Chi-Ching Chen Shui-Yi Tung Kuo-Liang Wei Chien-Heng Shen Te-Sheng Chang Wei-Ming Chen Huang-Wei Xu Chih-Wei Yen Yi-Hsing Chen Sheng-Nan Lu Chao-Hung Hung Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin Journal of the Formosan Medical Association |
author_facet |
Chi-Ching Chen Shui-Yi Tung Kuo-Liang Wei Chien-Heng Shen Te-Sheng Chang Wei-Ming Chen Huang-Wei Xu Chih-Wei Yen Yi-Hsing Chen Sheng-Nan Lu Chao-Hung Hung |
author_sort |
Chi-Ching Chen |
title |
Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin |
title_short |
Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin |
title_full |
Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin |
title_fullStr |
Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin |
title_full_unstemmed |
Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirin |
title_sort |
incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis c receiving sofosbuvir plus ribavirin |
publisher |
Elsevier |
series |
Journal of the Formosan Medical Association |
issn |
0929-6646 |
publishDate |
2020-01-01 |
description |
Background/Purpose: The major dose-limiting toxicity of ribavirin is hemolytic anemia. We investigated the incidence, risk factors and impact on virological response of anemia in chronic hepatitis C genotype 2 patients receiving sofosbuvir plus ribavirin therapy. Methods: This was a retrospective real-world analysis of a single center including 293 chronic hepatitis C genotype 2 patients treated with sofosbuvir plus ribavirin for 12 weeks. Severe anemia was defined as hemoglobin concentration <10 g/dl. Results: Treatment was completed in 285 (97%) of patients, of whom one withdrew due to severe anemia. Ribavirin dose reduction was required in 88 (30%) of patients. After excluding those with baseline hemoglobin <10 g/dl, 79 (29%) patients had developed severe anemia during therapy. Stepwise logistic regression analysis identified that chronic kidney disease (odds ratio [OR] = 3.970, p < 0.001), baseline hemoglobin level (OR = 0.475, p < 0.001) and baseline platelet count (OR = 0.992, p = 0.022) were independent factors. The sustained viral response 12 weeks off therapy (SVR12) rate was 93.9% in the per-protocol population. Multivariate analyses showed that history of hepatocellular carcinoma significantly reduced the efficacy of sofosbuvir plus ribavirin therapy (OR = 0.172, p = 0.001). Severe anemia, dose reduction or average dose (mg/kg/day) of ribavirin was not associated with SVR12. Conclusion: Severe anemia was not uncommon during sofosbuvir plus ribavirin therapy for chronic hepatitis C genotype 2 patients. Careful monitoring of anemia is necessary in patients with chronic kidney disease and low baseline hemoglobin level and platelet count. Keywords: Sofosbuvir, Ribavirin, Hepatitis C virus, Anemia, Sustained viral response |
url |
http://www.sciencedirect.com/science/article/pii/S0929664619304139 |
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doaj-13086ad5913a4056b336bce10fbc35cb2020-11-25T00:50:10ZengElsevierJournal of the Formosan Medical Association0929-66462020-01-011191532537Incidence, risk factors and impact on virological response of anemia in chronic genotype 2 hepatitis C receiving sofosbuvir plus ribavirinChi-Ching Chen0Shui-Yi Tung1Kuo-Liang Wei2Chien-Heng Shen3Te-Sheng Chang4Wei-Ming Chen5Huang-Wei Xu6Chih-Wei Yen7Yi-Hsing Chen8Sheng-Nan Lu9Chao-Hung Hung10Division of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Corresponding author. Division of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan.Background/Purpose: The major dose-limiting toxicity of ribavirin is hemolytic anemia. We investigated the incidence, risk factors and impact on virological response of anemia in chronic hepatitis C genotype 2 patients receiving sofosbuvir plus ribavirin therapy. Methods: This was a retrospective real-world analysis of a single center including 293 chronic hepatitis C genotype 2 patients treated with sofosbuvir plus ribavirin for 12 weeks. Severe anemia was defined as hemoglobin concentration <10 g/dl. Results: Treatment was completed in 285 (97%) of patients, of whom one withdrew due to severe anemia. Ribavirin dose reduction was required in 88 (30%) of patients. After excluding those with baseline hemoglobin <10 g/dl, 79 (29%) patients had developed severe anemia during therapy. Stepwise logistic regression analysis identified that chronic kidney disease (odds ratio [OR] = 3.970, p < 0.001), baseline hemoglobin level (OR = 0.475, p < 0.001) and baseline platelet count (OR = 0.992, p = 0.022) were independent factors. The sustained viral response 12 weeks off therapy (SVR12) rate was 93.9% in the per-protocol population. Multivariate analyses showed that history of hepatocellular carcinoma significantly reduced the efficacy of sofosbuvir plus ribavirin therapy (OR = 0.172, p = 0.001). Severe anemia, dose reduction or average dose (mg/kg/day) of ribavirin was not associated with SVR12. Conclusion: Severe anemia was not uncommon during sofosbuvir plus ribavirin therapy for chronic hepatitis C genotype 2 patients. Careful monitoring of anemia is necessary in patients with chronic kidney disease and low baseline hemoglobin level and platelet count. Keywords: Sofosbuvir, Ribavirin, Hepatitis C virus, Anemia, Sustained viral responsehttp://www.sciencedirect.com/science/article/pii/S0929664619304139 |