IL28B genotyping and treatment of HCV infected subjects

Background: Chronic hepatitis C is a common cause of advanced liver disease and appropriate treatment has been complex and a challenge. Reaction of individual genotypes to classical pegylated interferon-ribavirin therapy differs and no success has been achieved in some even after repeated therapy cycles. New types of so called directly acting antivirals (DAAs) are hopeful, as shown in many recent clinical studies, and triple therapy regimens involving DAA are becoming the new standard of care.

Objective: To summarize knowledge about the relationship between HCV therapeutic regimens and the genetic background of the host represented by interleukin 28B (IL28B) gene polymorphisms. In the first part, the host basic mechanisms in specific and innate immunity are introduced. The IL28B genotype and its role in the course of HCV treatment are described in the second part.

Methods: We searched and summarized publications on HCV therapeutic regimens and host IL28B polymorphisms.

Results: Compared to classical regimens, the association between IL28B polymorphism and treatment outcome of HCV infected patients is weaker in triple therapy using first generation DAAs boceprevir and telaprevir.

Conclusions: The association between IL28B polymorphism and treatment outcome is lessened with availability of new therapeutic regimens. Nevertheless, IL28B genotyping may still be useful for individualization of treatment strategies.