title: Impact of IL28B on the treatment decision in naïve and experienced patients with genotype 1 and 4 chronic hepatitis C in real-life clinical practice: a prospective multicenter cohort.
abstract: BACKGROUND
  The impact of the IL28B genotype on the real-life treatment decisions for patients infected with the hepatitis C virus (HCV) is unknown.
  
  
  OBJECTIVE
  To prospectively analyze the impact of IL28B genotype in HCV genotype 1 (G1)- or 4 (G4)-infected patients using buccal epithelial cell samples in real-life clinical practices.
  
  
  METHODS
  From October 2011 to March 2013, 1007 CHC patients were included among 127 French clinical centers.
  
  
  RESULTS
  The IL28B CC, CT, and TT genotype distribution was 252 (25%), 576 (57%), and 177 (18%), respectively. The treatment decisions were recorded and matched with the initial intentions for 433 patients. Multivariate analysis on intention to start treatment showed that patients with HCV G4 were less likely to be intended to be treated than HCV G1 patients (odds ratio [OR]=0.43 [95% CI 0.19-0.97], P=0.04); similarly HIV-HCV coinfected patients were less likely to be intended to be treated than HCV monoinfected patients (OR=0.20 [0.09-0.41], P<.0001); conversely, F3-F4 patients were more likely to be intended to be treated than F0-F2 patients (OR=2.24 [1.29-3.89], P=0.004). Multivariate analysis on final decision to treat showed that Patients with F3-F4 were more likely to be treated than others (OR=2.06 [1.26-3.38], P=0.004). Conversely, although P-values are not significant, patients recruited in public hospitals tended to be less treated (OR=0.65 [0.40-1.04], P=0.069), similarly to HIV-HCV coinfected patients (OR=0.55 [0.28-1.11], P=0.095).
  
  
  CONCLUSIONS
  Our study showed that the IL28B genotype is used for the management of HCV-infected patients. In the context of future treatments, IL28B genotyping may remain useful if it can be used to develop individualized treatment strategies, identifying patients who can be successfully treated with shorter, simpler, or cheaper regimens.
authors.affiliation: Hôpital Européen, Marseille, France. Electronic address: philippe.halfon@alphabio.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Halfon
authors.affiliation: Institut Arnault-Tzanck, Saint-Laurent-du-Var, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Ouzan
authors.affiliation: Hôpital Beaujon, Clichy, France.
authors.forename: Tarik
authors.initials: T
authors.lastname: Asselah
authors.affiliation: Hôpital d'Hyères, Hyères, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Renou
authors.affiliation: Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Allègre
authors.affiliation: Clinique du Palais, Grasse, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Delasalle
authors.affiliation: Hôpital Sainte-Musse, Toulon, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Lafeuillade
authors.affiliation: Centre Hospitalier Laennec, Créteil, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cadranel
authors.affiliation: Cabinet Médical, Maisons-Alfort, France.
authors.forename: Nabil
authors.initials: N
authors.lastname: Haddad
authors.affiliation: Association Génovir - Laboratoire Alphabio, Marseille, France.
authors.forename: Hacène
authors.initials: H
authors.lastname: Khiri
authors.affiliation: Association Génovir - Laboratoire Alphabio, Marseille, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pénaranda
authors.affiliation: Hôpital Saint-Joseph, Marseille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bourlière
mesh_terms: D004247:DNA / Q000032:analysis; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics*; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000737:chemistry; D011446:Prospective Studies; D000095022:Interferon Lambda
chemical_list: D004247:DNA; D007372:Interferons; D007378:Interleukins; C000624353:interferon-lambda, human; D000095022:Interferon Lambda