title: Meta-analysis: IL-28B genotype and sustained viral clearance in HCV genotype 1 patients.
abstract: BACKGROUND
  Polymorphisms in the IL-28B region are a strong predictor of sustained virologic response (SVR) in individual studies of HCV genotype 1 patients receiving peginterferon (pegIFN) and ribavirin.
  
  
  OBJECTIVE
  To obtain a pooled odds ratio (OR) of SVR in patients of varying race with the favourable IL-28B genotype compared to those with the unfavourable genotype.
  
  
  METHODS
  A literature search was conducted using online databases and a review of conference abstracts. A random effects meta-analysis was performed and study heterogeneity and publication bias were assessed.
  
  
  RESULTS
  There were 21 individual studies of HCV genotype 1 patients of varying ethnicity treated with pegIFN and ribavirin. The pooled prevalence of the favourable IL-28B genotype varied by race (73% vs. 41% vs. 13% in 2612 Asians, 3110 Caucasians and 452 African-Americans, respectively, P < 0.001). However, the strength of association of the IL-28B genotype with SVR was similar in all three racial groups (Caucasians: odds ratio (OR) 3.88, 2.75-5.49, African-Americans: OR 4.63, 2.52-8.50 and Asians OR 5.66, 3.99-8.02, all P < 0.001). The IL-28B genotype was also associated with SVR in 263 HIV/HCV co-infected Caucasians (OR 5.49, 3.02-9.96, P < 0.001). Study quality score and anti-viral treatment regimen did not impact the strength of the association in patient subgroups nor in the pooled population.
  
  
  CONCLUSIONS
  IL-28B genotype is significantly associated with SVR in HCV genotype 1 patients of varying race, as well as in HIV co-infected patients, receiving pegIFN and ribavirin. IL-28B testing in conjunction with other pre-treatment parameters may prove useful in counselling HCV patients.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Rangnekar
authors.forename: R J
authors.initials: RJ
authors.lastname: Fontana
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000145:classification*; D006526:Hepatitis C / Q000188:drug therapy / Q000235:genetics*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007372:Interferons; D007378:Interleukins / Q000235:genetics*; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use; D020641:Polymorphism, Single Nucleotide; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a