title: High predictability of a sustained virological response (87%) in chronic hepatitis C virus genotype 1 infection treatment by combined IL28B genotype analysis and γ-glutamyltransferase/alanine aminotransferase ratio: a retrospective single-center study.
abstract: BACKGROUND
  Chronic hepatitis C virus genotype 1 (HCV-G1) infection is treated with pegylated interferon-α and ribavirin. Predictive factors for treatment success are even more important now as direct-acting antiviral agents are available.
  
  
  METHODS
  Clinical and laboratory parameters were analyzed by uni- and multivariate statistical means in 264 patients with HCV-G1 infections with regard to treatment outcome.
  
  
  RESULTS
  The overall sustained virological response (SVR) rate was 44%. Univariate analyses revealed SVRs to be associated with age, high alanine aminotransferase (ALT) and low γ-glutamyltransferase (γ-GT) serum activities, a low pretreatment γ-GT/ALT ratio, rapid virological response (RVR), and absence of steatosis. Multivariate analyses unveiled IL28B rs12979860 genotype (CC vs. CT: OR = 2.8, CI: 1.5-4.9, p = 0.001; CC vs. TT: OR = 7.1, CI: 3.1-16.7, p < 0.001), low pretreatment γ-GT/ALT ratio (OR = 2.5, CI: 1.7-3.3, p < 0.001), age (OR = 0.96, CI: 0.94-0.98, p = 0.001) and RVR (OR = 4.18, CI: 2.85-8.65, p < 0.001) to be significantly related to treatment outcome. Patients with the IL28B rs12979860 CC genotype and a low pretreatment γ-GT/ALT ratio achieved the highest rate of a SVR with the highest predictive values (OR = 26.7, 95% CI: 10-71.1, p < 0.0001).
  
  
  CONCLUSIONS
  The pretreatment γ-GT/ALT ratio significantly enhances the predictability of the IL28B genotype. Employing this combination will help to identify patients who will most likely benefit from an interferon-α-based combination therapy in a nontriaged ordinary setting.
authors.affiliation: Division of Gastroenterology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Amanzada
authors.forename: A D
authors.initials: AD
authors.lastname: Goralczyk
authors.forename: S
authors.initials: S
authors.lastname: Schneider
authors.forename: F
authors.initials: F
authors.lastname: Moriconi
authors.forename: A
authors.initials: A
authors.lastname: Lindhorst
authors.forename: S
authors.initials: S
authors.lastname: Mihm
authors.forename: D H
authors.initials: DH
authors.lastname: Van Thiel
authors.forename: G
authors.initials: G
authors.lastname: Ramadori
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000998:Antiviral Agents / Q000627:therapeutic use; D004247:DNA / Q000235:genetics; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000378:metabolism / Q000821:virology*; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis*; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood*; D000095022:Interferon Lambda
chemical_list: D000410:Alanine Transaminase; D000998:Antiviral Agents; D004247:DNA; D007372:Interferons; D007378:Interleukins; D012367:RNA, Viral; D005723:gamma-Glutamyltransferase; C000624353:interferon-lambda, human; D000095022:Interferon Lambda