Tseng C-W, Hsieh Y-H, Chang C-K, Lai N-S, Hung T-H, Wu S-F, Tseng K-C
Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan.
Tissue Antigens. 2012 Nov;80(5):424-30. doi: 10.1111/j.1399-0039.2012.01956.x. Epub 2012 Aug 30.
To investigate the relationship between human leukocyte antigen (HLA) class I and II alleles and treatment-induced anemia in chronic hepatitis C (CHC) patients receiving combination therapy with pegylated interferon-α (PEG-IFN-α) and ribavirin (RBV). One hundred six naïve CHC patients (59 females and 47 males; mean age, 53.08 years) who underwent combination treatment were enrolled. The patients were considered positive for hemoglobin (Hb)-related side effects if the Hb concentrations dropped below 10 g/dl during PEG-IFN-α plus RBV treatment. The HLA-A, -B, -C, -DR, and -DQ loci were investigated by sequence-based genotyping. The effects of the clinical characteristics, virologic variables, and the HLA alleles on treatment-induced anemia were evaluated by a logistic regression analysis. Forty patients (37.7%) had Hb levels below 10 g/dl during the treatment course. Low baseline Hb levels and an advanced liver fibrosis stage were associated with decreases in Hb levels to below 10 g/dl. The occurrence of treatment-related anemia (Hb < 10 g/dl) was significantly associated with HLA-B15:02 as shown by multivariate analysis (adjusted odds ratio, 8.13; 95% confidence interval: 1.19-55.70; P-value after Holm's procedure, 0.03). HLA-B15:02 is associated with treatment-induced anemia in Taiwanese CHC patients receiving combination therapy with PEG-IFN-α plus RBV.
为研究人类白细胞抗原（HLA）I类和II类等位基因与接受聚乙二醇化干扰素-α（PEG-IFN-α）和利巴韦林（RBV）联合治疗的慢性丙型肝炎（CHC）患者治疗诱导的贫血之间的关系。纳入106例接受联合治疗的初治CHC患者（59例女性和47例男性；平均年龄53.08岁）。如果在PEG-IFN-α加RBV治疗期间血红蛋白（Hb）浓度降至10 g/dl以下，则这些患者被认为存在与Hb相关的副作用。通过基于序列的基因分型研究HLA-A、-B、-C、-DR和-DQ基因座。通过逻辑回归分析评估临床特征、病毒学变量和HLA等位基因对治疗诱导贫血的影响。40例患者（37.7%）在治疗过程中Hb水平低于10 g/dl。低基线Hb水平和晚期肝纤维化阶段与Hb水平降至10 g/dl以下相关。多因素分析显示，治疗相关贫血（Hb < 10 g/dl）的发生与HLA-B15:02显著相关（调整比值比，8.13；95%置信区间：1.19 - 55.70；Holm法后的P值，0.03）。在接受PEG-IFN-α加RBV联合治疗的台湾CHC患者中，HLA-B15:02与治疗诱导的贫血相关。
