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IL28B polymorphisms determine early viral kinetics and treatment outcome in patients receiving peginterferon/ribavirin for chronic hepatitis C genotype 1

Journal article
Authors Magnus Lindh
Martin Lagging
B Arnholm
Anders Eilard
Staffan Nilsson
Gunnar Norkrans
Jonas Söderholm
T Wahlberg
Rune Wejstål
Johan Westin
Kristoffer Hellstrand
Published in Journal of Viral Hepatitis
Volume 18
Issue 7
Pages e325-e331
ISSN 1352-0504
Publication year 2011
Published at Department of Mathematical Sciences, Mathematical Statistics
Institute of Biomedicine, Department of Infectious Medicine
Pages e325-e331
Language en
Links dx.doi.org/10.1111/j.1365-2893.2010...
Keywords Adult, Antiviral Agents, administration & dosage, therapeutic use, Female, Genotype, Hepacivirus, drug effects, genetics, physiology, Hepatitis C, Chronic, drug therapy, Humans, Interferon-alpha, administration & dosage, therapeutic use, Interleukins, genetics, Kinetics, Linkage Disequilibrium, genetics, Male, Middle Aged, Polyethylene Glycols, administration & dosage, therapeutic use, Polymorphism, Single Nucleotide, Prognosis, Recombinant Proteins, administration & dosage, therapeutic use, Ribavirin, administration & dosage, therapeutic use, Treatment Outcome
Subject categories Microbiology in the medical area, Infectious Medicine

Abstract

Single nucleotide polymorphisms (SNPs) upstream of IL28B predict the outcome of treatment in chronic hepatitis C virus (HCV) infection, but their impact on viral kinetics and relation to other predictors are not well known. Here, two SNPs, rs12979860 and rs8099917, were analysed and related to early viral kinetics during treatment in 110 patients with HCV genotype 1 infection. The reduction of HCV RNA after 7 days of therapy was more pronounced (P < 0.0001) in patients with CC(rs12979860) or TT(rs8099917) than in patients carrying TT(rs12979860) or GG(rs8099917), respectively. The two SNPs were in linkage disequilibrium (d' = 1, r2 = 0.44), but CC(rs12979860) was less common (43% vs. 71%) than TT(rs8099917). Patients carrying both CC(rs12979860) and TT(rs8099917) genotypes achieved lower levels of HCV RNA at week 4 than those with CT or TT at rs12979860 and TT(rs8099917) (P = 0.0004). The viral elimination was significantly influenced by rs12979860 independently of baseline viral load, age or fibrosis. This translated into high rates of sustained viral response (SVR) among patients carrying CC(rs12979860) despite the presence of high viral load at baseline (SVR 74%), high age (SVR 79%) or severe liver fibrosis (SVR 83%). We conclude that the IL28B variability influences the antiviral efficiency of interferon/ribavirin therapy and has a strong impact on SVR, independently of traditional response predictors. A combined assessment of these SNPs in conjunction with other response predictors may better predict outcome in difficult-to-treat patients.

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