Host genetic variants in the pathogenesis of hepatitis C.
Direct-acting antiviral drugs (DAAs) are currently replacing antiviral therapy for Hepatitis C infection. Treatment related side effects are even worse and the emergence of resistant viruses must be avoided because of the direct-antiviral action. Altogether it remains a challenge to take treatment decisions in a clinical setting with cost restrictions. Genetic host factors are hereby essential to implement an individualized treatment concept. In recent years results on different genetic variants have been published with a strong association with therapy response, fibrosis and treatment-related side effects. Polymorphisms of the IL28B gene were identified as accurate predictors for therapy response and spontaneous clearance of HCV infection and are already used for diagnostic decisions. For RBV-induced side effects, such as hemolytic anemia, associations to genetic variants of inosine triphosphatase (ITPA) were described and different SLC28 transporters for RBV-uptake have been successfully analyzed. Fibrosis progression has been associated with variants of Vitamin D receptor (VDR) and ABCB11 (bile salt export pump). Cirrhotic patients especially have a high treatment risk and low therapy response, so that personalized antiviral treatment is mandatory. This review focuses on different host genetic variants in the pathogenesis of Hepatitis C at the beginning of a new area of treatment.
Division of Hepatology, Department of Internal Medicine II, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany. rau_m@medizin.uni-wuerzburg.de
Monika
M
Rau
Katharina
K
Baur
Andreas
A
Geier
D000074020:ATP Binding Cassette Transporter, Subfamily B, Member 11; D018528:ATP-Binding Cassette Transporters / Q000235:genetics; D000998:Antiviral Agents / Q000627:therapeutic use*; D004198:Disease Susceptibility; D020022:Genetic Predisposition to Disease; D016174:Hepacivirus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000175:diagnosis* / Q000235:genetics*; D054884:Host-Pathogen Interactions; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D026901:Membrane Transport Proteins / Q000235:genetics; D011755:Pyrophosphatases / Q000235:genetics; D018167:Receptors, Calcitriol / Q000235:genetics; D012254:Ribavirin / Q000009:adverse effects; D016896:Treatment Outcome; D000095022:Interferon Lambda; D000097630:Inosine Triphosphatase
D000074020:ATP Binding Cassette Transporter, Subfamily B, Member 11; D018528:ATP-Binding Cassette Transporters; D000998:Antiviral Agents; D007372:Interferons; D007378:Interleukins; D026901:Membrane Transport Proteins; D011755:Pyrophosphatases; D018167:Receptors, Calcitriol; D012254:Ribavirin; C093491:ABCB11 protein, human; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C579457:VDR protein, human; C065171:cif nucleoside transporter; C511829:ITPA protein, human; D000097630:Inosine Triphosphatase