Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype

BMC Gastroenterology

Yoshihiko Maehara¹  Jun Hayashi³  Takasuke Fukuhara²  Morimasa Tomikawa¹  Tomohiko Akahoshi¹  Yuji Soejima¹  Toru Ikegami¹  Tomoharu Yoshizumi¹  Norihiro Furusyo³  Ken Shirabe¹  Takashi Motomura¹ 

[1] Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan;Department of Molecular Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan;Department of General Internal Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

关键词: Liver cirrhosis;    Splenectomy;    ITPA;    IL28B;   

Others  :  858307
DOI  :  10.1186/1471-230X-12-158

 received in 2012-04-12, accepted in 2012-10-11,  发布年份 2012

【 摘 要 】

Background

IL28B and ITPA genetic variants are associated with the outcome of pegylated-interferon and ribavirin (PEG-IFN/RBV) therapy. However, the significance of these genetic variants in cirrhotic patients following splenectomy has not been determined.

Methods

Thirty-seven patients with HCV-induced cirrhosis who underwent laparoscopic splenectomy (Spx group) and 90 who did not (non-Spx group) were genotyped for IL28B and ITPA. The outcome or adverse effects were compared in each group. Interferon-stimulated gene 15 (ISG15) and protein kinase R expression in the spleen was measured using total RNA extracted from exenterate spleen.

Results

Sustained virological response (SVR) rate was higher in patients carrying IL28B major genotype following splenectomy (50% vs 27.3%) and in patients carrying minor genotype in the Spx group compared to non-Spx group (27.3% vs 3.6%, P < 0.05). Pretreatment splenic ISG expression was higher in patients carrying IL28B major. There was no difference in progression of anemia or thrombocytopenia between patients carrying each ITPA genotype in the Spx group. Although splenectomy did not increase hemoglobin (Hb) level, Hb decline tended to be greater in the non-Spx group. In contrast, splenectomy significantly increased platelet count (61.1 × 10³/μl vs 168.7 × 10³/μl, P < 0.01), which was maintained during the course of PEG-IFN/RBV therapy.

Conclusions

IL28B genetic variants correlated with response to PEG-IFN/RBV following splenectomy. Splenectomy improved SVR rate among patients carrying IL28B minor genotype and protected against anemia and thrombocytopenia during the course of PEG-IFN/RBV therapy regardless of ITPA genotype.

【 授权许可】

   
2012 Motomura et al.; licensee BioMed Central Ltd.

【 图 表 】

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