title: [The value of genetics in the era of hepatitis C triple therapy].
abstract: Despite the introduction of protease inhibitors (PI) in the treatment of hepatitis C, the sensitivity of interferon continues to be essential to achieve a sustained virological response (SVR) and to eradicate the viral infection. Currently, pegylated interferon (PEG-IFN) and ribavirin (RBV) are required to avoid selection of PI-resistance mutations. The likelihood of obtaining an SVR with dual therapy in treatment-naïve patients with genotype 1 infection varies from 40% to 50%. That is, almost half of these patients would not require a PI, thus avoiding their adverse effects and considerably reducing the cost of the treatment. Identifying which patients could potentially respond to dual therapy is one of the main challenges in clinical practice. The genetic variability of the host is one of the main factors affecting the sensitivity of PEG-IFN and therefore in the response to current treatment. Other baseline factors related to the host, the virus and, especially, to intratreatment factors such as rapid virological response (RVR) are strongly associated with the probability of achieving an SVR. The evidence on the decision to prescribe dual or triple therapy according to the factors predictive of response is based on retrospective studies or post-hoc analyses of pivotal studies on PI. Study of the polymorphisms of the IFNL3 gene (IL28B), ITPA, IFN-stimulated genes (ISGs), TT/ΔG (ss469415590; IFNL4)) and RBV transporters could help in the decision to prescribe dual or triple therapy in treatment naïve patients.
authors.affiliation: Unidad de Apoyo a la Investigación, Hospital Universitario San Cecilio, Granada, España; CIBERehd, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Quiles-Pérez
authors.affiliation: Unidad de Apoyo a la Investigación, Hospital Universitario San Cecilio, Granada, España.
authors.forename: Esther José
authors.initials: EJ
authors.lastname: Pavón-Castillero
authors.affiliation: Unidad de Apoyo a la Investigación, Hospital Universitario San Cecilio, Granada, España; CIBERehd, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Paloma
authors.initials: P
authors.lastname: Muñoz-de-Rueda
authors.affiliation: UGC de Aparato Digestivo, Hospital Virgen Macarena, Sevilla, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Carmona
authors.affiliation: CIBERehd, Instituto de Salud Carlos III, Madrid, España; UGC de Aparato Digestivo, Hospital Universitario San Cecilio, Granada, España. Electronic address: fsalmero@ugr.es.
authors.forename: Javier
authors.initials: J
authors.lastname: Salmerón
mesh_terms: D000740:Anemia / Q000209:etiology; D000998:Antiviral Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: Chronic hepatitis C; Genetic markers; Hepatitis crónica C; IFNL3; ITPA; Inhibidores de la proteasa; Inosina trifosfato pirofosfatasa; Interferón lamda 3; Marcadores genéticos; Protease inhibitors; Rapid virological response; Respuesta virológica rápida