Abstract
Aim & Background: It was proposed that the differences in erythrocyte membrane protein contents—especially band 4—take a role in the serious anemia related to interferon plus ribavirin (I/R). The aim of this study is to evaluate whether the erythrocyte membrane protein contents predict anemia related to I/R or not. Methods: 180 mcg interferon α 2a once a week and weight adjusted ribavirin daily were given for 48 weeks to fifty patients with chronic hepatitis C. It was diagnosed as anemia when haemoglobin concentration was <10 mg/dL. In the beginning, the erythrocyte membrane protein contents of all patients were separated by “Sodium Dodecyl Sulphate Polyacrylamide Gel Disc Electrophoresis (SDS-PAGE)” and haemoglobin concentrations were measured. Results: Anemia developed in 17 patients (34%). The levels of erythrocyte membrane proteins were as; spectrin: 20.468 ± 2.5902, ankyrin: 4.576 ± 1.2706, B3: 19.240 ± 2.8358, B4.1: 5.628 ± 1.8832, and B4.2: 5.848 ± 1.8030. When the relation between the development of anemia and erythrocyte membrane proteins was investigated, a relation was only found at B3 which was not statistically significant (p = 0.058). When ROC analysis was performed, 95% CI p = 0.035 for B3 (0.517 - 0.792) was found. In patients whose B3 level was below 17.7%, the sensitivity of anemia development risk was calculated as 64.7% and the specificity thereof was calculated as 66.7%. Erythrocyte membrane protein contents by gender were only different at B3 (p = 0.042). Anemia developed in 17 patients (34%). 14 of these patients were of female and 3 were of male gender; the gender played a significant role in terms of anemia (p = 0.003). Conclusions: Erythrocyte membrane protein B3 is not only useful in predicting the patient under the risk of developing anemia, but also it may be useful in preventing it and it may explain why women inclined to anemia.
Highlights
The current standard of care for the treatment of chronic hepatitis C is peginterferon and ribavirin, which can induce a sustained virological response (SVR) in the majority of patients treated [1] [2].Ribavirin is a purine nucleoside analogue [3]
Aim & Background: It was proposed that the differences in erythrocyte membrane protein contents—especially band 4—take a role in the serious anemia related to interferon plus ribavirin (I/R)
In patients whose Band 3 (B3) level was below 17.7%, the sensitivity of anemia development risk was calculated as 64.7% and the specificity thereof was calculated as 66.7%
Summary
The current standard of care for the treatment of chronic hepatitis C is peginterferon and ribavirin, which can induce a sustained virological response (SVR) in the majority of patients treated [1] [2].Ribavirin is a purine nucleoside analogue [3]. The treatment of patients with hepatitis C consists of interferon-α and ribavirin combination therapy [4] [5]. Combination therapy, in comparison to single-agent interferon treatment, leads to an increase in side effects [4]-[11]. Dose reductions are common and they are essentially required in 10% of patients under combination therapy who develop anemia [3] [4] [5] [6] [7]. The major toxicity related to ribavirin use is haemolytic anemia. This side effect has been associated with the accumulation of ribavirin triphosphate in red blood cells (RBCs), leading to the inhibition of erythrocyte functions [12] [13]
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