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Details

Autor(en) / Beteiligte
Titel
IL28B polymorphism as a predictor of antiviral response in chronic hepatitis C
Ist Teil von
  • World journal of gastroenterology : WJG, 2012-09, Vol.18 (35), p.4892-4897
Ort / Verlag
United States: Baishideng Publishing Group Co., Limited
Erscheinungsjahr
2012
Quelle
MEDLINE
Beschreibungen/Notizen
  • AIM: To evaluate the effect of single nucleotide poly- morphisms of interleukin (IL)-28B, rs12979860 on progression and treatment response in chronic hepatitis C. METHODS: Patients (n = 64; 37 men, 27 women; mean age, 44 + 12 years) with chronic hepatitis C, genotype 1, received treatment with peg-interferon plus ribavirin. Genotyping of rs12979860 was per- formed on peripheral blood DNA. Histopathological assessment of necroinflammatory grade and fibrosis stage were scored using the METAVIR system on a liver biopsy sample before treatment. Serum viral load, ami- notransferase activity, and insulin level were measured. Insulin resistance index, body mass index, waist/hip ratio, percentage of body fat and fibrosis progression rate were calculated. Applied dose of interferon and ribavirin, platelet and neutrophil count and hemoglobin level were measured. RESULTS: A sustained virological response (SVR) was significantly associated with IL28B polymorphism (CC vs -l-r allele: odds ratio (OR), 25; CC vs CT allele: OR, 5.4), inflammation activity (G 〈 1 vs G 〉 1: OR, 3.9), fibrosis (F 〈 1 vs F 〉 1: OR, 5.9), platelet count (〉 200 × 109/L vs 〈 200 ×109/L: OR, 4.7; OR in patients with genotype CT: 12.8), fatty liver (absence vs presence of steatosis: OR, 4.8), insulin resistance index (〈 2.5 vs 〉 2.5: OR, 3.9), and baseline HCV viral load (〈 106 IU/mL vs 〉 106 IU/mL: OR, 3.0). There was no association with age, sex, aminotransferases activity, body mass index, waist/hip ratio, or percentage body fat. There was borderline significance (P = 0.064) of increased fibrosis in patients with the I-I allele, and no differences in the insulin resistance index between groups of patients with CC, CT and -IF alleles (P = 0.12). Spearman's rank correlation coefficient between insulin resistance and stage of fibrosis and body mass index was r = 0.618 and r = 0.605, respectively (P 〈 0.001). Significant dif- ferences were found in the insulin resistance index (P = 0.01) between patients with and without steatosis. Patients with the C-I- allele and absence of a SVR had a higher incidence of requiring threshold dose reduction of interferon (P = 0.07). CONCLUSION: IL28B variation is the strongest host factor not related to insulin resistance that determines outcome of antiviral therapy. Baseline platelet count predicts the outcome of antiviral therapy in CT allele patients.

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