There are no potential conflicts of interest to declare.
Value of Interleukin 28B Genetic Polymorphism on Retreatment Outcomes of Chronic Hepatitis C Genotype 1 Relapsers by Peginterferon Alfa plus Ribavirin
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Journal of Gastroenterology and Hepatology
None of the materials and results has been presented or published previously.
No writing assistance was provided.
Financial disclosure: The work was supported by grants from the National Taiwan University; the National Science Council and Department of Health, Executive Yuan, Taiwan; National Taiwan University Hospital, Taiwan.
Abbreviations: HCV, hepatitis C virus; EVR, early virologic response; SVR, sustained virologic response; RVR, rapid virologic response; SNP, single nucleotide polymorphism
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jgh.12329
- Accepted manuscript online: 5 JUL 2013 06:29AM EST
- Manuscript Accepted: 22 JUN 2013
- chronic hepatitis C;
- pegylated interferon;
Chronic hepatitis C infection (CHC) is a leading cause of cirrhosis and hepatocellular carcinoma worldwide. Pegylated interferon (PEG-IFN) plus ribavirin (RBV) combination therapy remains the standard-of-care for CHC genotype 1 in many Asian countries; and single nucleotide polymorphism or genotype of the interleukin-28B (IL28B) gene is associated with the development of sustained virologic response (SVR). The predictive value of IL28B genotype for retreatment outcomes of patients with CHC was only partly clarified and deserves further investigation.
A total of 75 CHC genotype 1 Taiwanese patients who relapsed after 24-week PEG-IFN/RBV combination therapy and received retreatment with a 48-week PEG-IFN/RBV therapy were consecutively enrolled since November 2009. The associations among IL28B rs8099917 genotype, virologic kinetics, and treatment outcomes were evaluated.
Rapid virologic response (RVR) at week 4, end-of-treatment virologic response (EOT-VR) and SVR was 37%, 73% and 52%, respectively. Relapse rate was 29%. None of patients had rs8099917 GG genotype. Patients with TT genotype (n=54, 72%) had higher rates of RVR (50% vs. 5%, P=0.0002), EOT-VR (85% vs. 43%, P=0.0001) and SVR (67% vs. 14%, P=0.0001) than those with GT genotype (n=21, 28%). Combination of IL28B TT genotype and achieving RVR had 85% positive and 90% negative predictive values of SVR.
About half of the Taiwanese CHC relapsers to a previous 24-week combination therapy achieve SVR after retreatment for 48 weeks. IL28B genotype influences on-treatment viral kinetics and SVR rate in these retreated patients. Baseline IL28B genotype and RVR can serve as early predictors for treatment success.