Introduction Patients with chronic hepatitis C virus (HCV) infection have a variable response to antiviral therapy with pegylated interferon and ribavirin. Influences include age, gender, viral genotype, viral load, severity of liver disease and coinfection. Around 45% of patients with viral genotype 1(G1) infection respond compared with 70%–80% with genotype 2/3. Recently a human IL28B polymorphism has been found to predict response in patients with G1 infection. There is little data on this from Europe and a study of IL28B polymorphisms in patients with G1 infection treated in Glasgow was conducted.
Methods Sequential Caucasian patients with G1 chronic HCV who had been treated with combination antiviral therapy were studied. Responses were classified as sustained viral response (SVR), relapse (R) or non-responder (NR). None had coinfection. Data on age, gender, viral load, duration of therapy and severity of liver disease (Ishak fibrosis stage <4 or ≥4) were collected. Individuals were genotyped for IL28B polymorphism rs12979860 using TaqMan®, Drug Metabolism Genotyping Assays and reported as CC, CT or TT.
Results 63 patients were classified (number, mean age, females, advanced fibrosis) by treatment response as SVR (18, 44, 4, 1), R (20, 46, 8, 8) and NR (25, 46.4, 4, 10). Mean pre-treatment viral load was similar in the three groups (5.2, 5.4, 5.8 log10 IU/ml) and mean duration of therapy shorter for NR (46.2, 47.2, 8.4 weeks) who often fulfilled an early stopping rule. The IL28B genotype was highly predictive of response (Abstract PMO-183 table 1). CC individuals have a much greater likelihood (p<0.002) of being in the SVR group than CT or TT individuals. Poorer response was also seen in patients with advanced fibrosis.
Conclusion The IL28B polymorphism is a useful and cheap assay allowing some prediction of response to antiviral therapy in patients with G1 chronic HCV infection.
Competing interests None declared.
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