Abstract: Objective The aim of this study was to explore the impact of inosine triphosphatase genotype (ITPA) gene rs1127354 polymorphism on ribavirin (RBV)-related hemolysis in patients with chronic hepatitis C (CHC) receiving pegylated interferon alpha-2a and RBV (PR) therapy. Methods 235 patients with CHC were recruited in our hospital between March 2016 and March 2018, and all patients received PR therapy for 24 to 48 weeks. The blood ITPA gene locus rs1127354 were detected by gene sequencing. Results The gene sequencing showed that ITPA genotype rs1127354 locus were CC in 93 and AA/AC in 42; 188 patients with CHC (152 with CC and 36 with AA/AC) completed the 24-week antiviral regimen, and the rapid virological response (RVR) and early virological response (EVR) in patients with genotype AA/AC were 44.4% and 47.2%, not significantly different as compared to 42.1% and 42.7% in those with genotype CC(P>0.05), while the sustained virological response (SVR) was 72.2%, significantly higher than 53.3%(P<0.05) in patients with genotype CC; at the end of week 4, 8, 12 and 24, blood hemoglobin levels in patients with genotype AA/AC were (138.2±14.7) g/L, (130.5±12.6) g/L, (123.7±12.5)g/L and (118.0±10.2)g/L, significantly higher than 【(132.3±13.9)g/L, (113.1±10.5)g/L, (108.4±9.4)g/L and (106.7±11.3)g/L, respectively, P＜0.05】 in patients with genotype CC. Conclusion The CHC patients with ITPA genotype CC are more prone to RBV-related hemolysis during PR antiviral therapy, which should be taken into consideration in clinical decision-making process.

Key words: Hepatitis C, Inosine triphosphatase genotype, Ribavirin-related hemolysis, Sustained virological response