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World J Hepatol. Oct 27, 2014; 6(10): 759-765
Published online Oct 27, 2014. doi: 10.4254/wjh.v6.i10.759
Predictability of IL-28B-polymorphism on protease-inhibitor-based triple-therapy in chronic HCV-genotype-1 patients: A meta-analysis
Nicolae-Catalin Mechie, Christian Röver, Silke Cameron, Ahmad Amanzada
Nicolae-Catalin Mechie, Silke Cameron, Ahmad Amanzada, Department of Gastroenterology and Endocrinology, University Medical Center Goettingen, Georg-August-University, 37075 Goettingen, Germany
Christian Röver, Department of Medical Statistics, University Medical Center Goettingen, Georg-August-University, 37073 Goettingen, Germany
Author contributions: Mechie NC and Röver C contributed equally; Mechie NC works as resident, specializing in gastroenterology and hepatology; the statistical analysis was performed by Röver C; he is medical statistician; Amanzada A formulated the study concept; he is specialized in internal medicine, his research focus is hepatology; Mechie NC and Amanzada A independently made the data extraction; Amanzada A, Mechie NC and Röver C analyzed the research quality and interpreted the data; Cameron S critically revised the manuscript for intellectual content; she is specialized in internal medicine and gastroenterology; all authors contributed to the writing of the manuscript and approved it.
Correspondence to: Dr. med. Ahmad Amanzada, MD, Division of Gastroenterology and Endocrinology, University Medical Center Goettingen, Georg-August-University, Robert-Koch-Straße 40, 37075 Goettingen, Germany.
Telephone: +49-551-3920146 Fax: +49-551-396921
Received: June 6, 2014
Revised: July 29, 2014
Accepted: September 6, 2014
Published online: October 27, 2014

AIM: To investigate the predictability of interleukin-28B single nucleotide polymorphism rs12979860 with respect to sustained virological response (SVR) in chronically hepatitis C virus (HCV) genotype-1 patients treated with a protease-inhibitor and pegylated interferon-α (Peg-INF-α) based triple-therapy.

METHODS: We searched PubMed, the Cochrane Library and Web of Knowledge for studies regarding the interleukin 28B (IL-28B)-genotype and protease-inhibitor based triple-therapy. Ten studies with 2707 patients were included into this meta-analysis. We used regression methods in order to investigate determinants of SVR.

RESULTS: IL-28B-CC-genotype patients achieved higher SVR rates (odds 5.34, 95%CI: 3.81-7.49) than IL-28B-non-CC-genotype patients (1.88, 95%CI: 1.43-2.48) receiving triple-therapy. The line of therapy (treatment-naïve or -experienced for Peg-INF-α) did not affect the predictive value of IL-28B (P = 0.1). IL-28B-CC-genotype patients treated with protease inhibitor-based triple-therapy consisting of Boceprevir, Simeprevir, Telaprevir or Vaniprevir showed odds of 3.38, 14.66, 7.84 and 2.91, respectively. The odds for CC genotype patients treated with Faldaprevir cannot be quantified, as only a single study with a 100% SVR rate was available.

CONCLUSION: IL-28B-SNP predicts the outcome for chronic HCV genotype-1 patients receiving protease inhibitor-based triple-therapy. The predictive value varies between the different protease inhibitors.

Keywords: Hepatitis C virus, Direct antiviral agents, Interleukin 28B, Sustained virological response, Meta-analysis

Core tip: Hepatitis C is a world health problem and represents a dynamic field of research for new therapeutic options. Recently direct antiviral agents such as protease inhibitors have been developed which, in addition to pegylated interferon-α and Ribavirin, obtain higher sustained virological response (SVR) rates. Of note, costs are higher and side effects are more common. The data regarding the predictive value of Interleukin 28B (IL-28B) are controversial. This meta-analysis was conducted on 2707 patients treated with different protease inhibitors. Its aim was to clarify the predictive value of IL-28B on SVR in protease inhibitor-based triple-therapy, allowing the possibility of personalized treatment.