Personalized therapies for patients with chronic Hepatitis C

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Video: IL28B gene and hepatitis c treatment

January's publications of the American Journal of Gastroenterology investigates IL28B genomic-based treatment paradigms for patients with chronic Hepatitis C infection.

Genome-wide association studies have recently identified host genetic variation to be critical for predicting treatment response and spontaneous clearance in patients infected with hepatitis C virus.

Dr Paul Clark and colleagues from North Carolina, USA reviewed these important new studies and discussed their future clinical implications.

Single-nucleotide polymorphisms in the region of the IL28B gene on chromosome 19, coding for the interferon (IFN)-λ-3 or IL28B gene, are strongly associated with treatment response to pegylated IFN and ribavirin in patients infected with genotype 1 Hepatitis C virus.
The research team found that the good response variant is associated with a twofold increase in the rate of cure.

Allele frequencies differ between ethnic groups, largely explaining the observed differences in response rates between Caucasians, African Americans and Asians. IL28B polymorphism is also strongly associated with spontaneous clearance of Hepatitis C virus.
The researchers found that the biological mechanisms responsible for these genetic associations remain unknown and are the focus of ongoing research.
Knowledge of a patient's IL28B genotype is likely to aid in clinical decision making with standard of care regimens.

Dr Clark's team concludes, "Future studies will investigate the possibility of individualizing treatment duration and novel regimens according to IL28B type."

Am J Gastroenterol 2011; 106: 38–4719 January 2011