Interleukin-28B polymorphism improves viral kinetics and is the strongest pretreatment predictor of sustained virologic response in genotype 1 hepatitis C virus.
OBJECTIVE
We recently identified a polymorphism upstream of interleukin (IL)-28B to be associated with a 2-fold difference in sustained virologic response (SVR) rates to pegylated interferon-alfa and ribavirin therapy in a large cohort of treatment-naive, adherent patients with chronic hepatitis C virus genotype 1 (HCV-1) infection. We sought to confirm the polymorphism's clinical relevance by intention-to-treat analysis evaluating on-treatment virologic response and SVR.


METHODS
HCV-1 patients were genotyped as CC, CT, or TT at the polymorphic site, rs12979860. Viral kinetics and rates of rapid virologic response (RVR, week 4), complete early virologic response (week 12), and SVR were compared by IL-28B type in 3 self-reported ethnic groups: Caucasians (n = 1171), African Americans (n = 300), and Hispanics (n = 116).


RESULTS
In Caucasians, the CC IL-28B type was associated with improved early viral kinetics and greater likelihood of RVR (28% vs 5% and 5%; P < .0001), complete early virologic response (87% vs 38% and 28%; P < .0001), and SVR (69% vs 33% and 27%; P < .0001) compared with CT and TT. A similar association occurred within African Americans and Hispanics. In a multivariable regression model, CC IL-28B type was the strongest pretreatment predictor of SVR (odds ratio, 5.2; 95% confidence interval, 4.1-6.7). RVR was a strong predictor of SVR regardless of IL-28B type. In non-RVR patients, the CC IL-28B type was associated with a higher rate of SVR (Caucasians, 66% vs 31% and 24%; P < .0001).


CONCLUSIONS
In treatment-naive HCV-1 patients treated with pegylated interferon and ribavirin, a polymorphism upstream of IL-28B is associated with increased on-treatment and sustained virologic response and effectively predicts treatment outcome.
Thompson
Alexander J
AJ
Duke Clinical Research Institute, Durham, North Carolina, USA.
Muir
Andrew J
AJ
Sulkowski
Mark S
MS
Ge
Dongliang
D
Fellay
Jacques
J
Shianna
Kevin V
KV
Urban
Thomas
T
Afdhal
Nezam H
NH
Jacobson
Ira M
IM
Esteban
Rafael
R
Poordad
Fred
F
Lawitz
Eric J
EJ
McCone
Jonathan
J
Shiffman
Mitchell L
ML
Galler
Greg W
GW
Lee
William M
WM
Reindollar
Robert
R
King
John W
JW
Kwo
Paul Y
PY
Ghalib
Reem H
RH
Freilich
Bradley
B
Nyberg
Lisa M
LM
Zeuzem
Stefan
S
Poynard
Thierry
T
Vock
David M
DM
Pieper
Karen S
KS
Patel
Keyur
K
Tillmann
Hans L
HL
Noviello
Stephanie
S
Koury
Kenneth
K
Pedicone
Lisa D
LD
Brass
Clifford A
CA
Albrecht
Janice K
JK
Goldstein
David B
DB
McHutchison
John G
JG
D000328:Adult; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy / Q000235:genetics* / Q000821:virology; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020641:Polymorphism, Single Nucleotide; D019562:Viral Load; D000095022:Interferon Lambda
D007372:Interferons; D007378:Interleukins; C000624353:interferon-lambda, human; D000095022:Interferon Lambda