Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.8924
Revised: October 30, 2013
Accepted: November 28, 2013
Published online: December 21, 2013
Single nucleotide polymorphisms near the interleukin 28B (IL-28B) gene have been identified as strong predictors of both spontaneous or Peg-interferon (Peg-IFN) and ribavirin (RBV) induced clearance of hepatitis C virus (HCV). Several studies have shown that, in patients with genotype 1 (GT-1), rs12979860 C/C and rs8099917 T/T substitutions are associated with a more than twofold increase in sustained virological response rate to Peg-IFN and RBV treatment. Although new treatment regimens based on combination of DAA with or without IFN are in the approval phase, until combination regimens with a backbone of Peg-IFN will be used, we can expect that IL28B holds its importance. The clinical relevance of IL28B genotyping in treatment of patients infected with HCV genotype 2 (GT-2) and 3 (GT-3) remains controversial. Therefore, after a careful examination of the available literature, we analyzed the impact of IL28B in GT-2 and -3. Simple size of the studies and GT-2 and GT-3 proportion were discussed. An algorithm for the practical use of IL28B in these patients was suggested at the aim of optimizing treatment.
Core tip: The clinical relevance of interleukin 28B genotyping in patients with hepatitis C virus genotype 2 and 3 infection is debated. In this critical analysis of studies performed so far, it was shown that this genetic tool may help in optimizing treatment of genotype 3 patients, whilst it plays a marginal role in genotype 2 infected patients management.