Single Nucleotide Polymorphisms Associated with Elevated Alanine Aminotransferase in Patients Receiving Asunaprevir Plus Daclatasvir Combination Therapy for Chronic Hepatitis C

The study analyzed the effects of single nucleotide polymorphisms (SNPs) on alanine aminotransferase (ALT) levels in 185 Japanese patients with chronic hepatitis C genotype 1b, treated with asunaprevir plus daclatasvir. It was found that the SNP CYP3A4 rs4646437 was significantly associated with elevated ALT levels, with patients having the CC genotype showing higher maximum ALT values than those with the non-CC genotype. The study concluded that the CYP3A4 rs4646437 CC genotype and cirrhosis were significant independent factors for grade >1 ALT elevation, with odds ratios of 2.83 and 1.88, respectively. Additionally, higher serum concentrations of asunaprevir were observed in patients with grade >1 ALT elevation. These findings suggest that SNP genotyping could be beneficial for monitoring and ensuring the safe completion of treatment in patients. However, the study's retrospective nature and the small sample size indicate a need for further research to confirm these results.