Revised: September 2, 2013
Accepted: October 16, 2013
Published online: November 27, 2013
The average age of hepatitis C virus (HCV)-infected individuals is becoming increasingly higher in Japan and steps should be taken to treat older individuals infected with HCV. Until an interferon-free regimen becomes available, peginterferon plus ribavirin will play a critical role in the treatment. The perception that older HCV-infected patients may be at higher risk than younger patients for adverse events from peginterferon plus ribavirin treatment but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials. A recent genome-wide association study revealed that interleukin-28B (IL28B) genotype closely correlates with the treatment response against HCV. The relationship of IL28B genotype with the treatment response in older HCV-infected patients is also unknown. In this review, we focused on the treatment response in older patients infected with HCV and the effects of IL28B genotype. IL28B major genotype is a useful predictor of sustained virological response in the interferon-including treatment of older patients infected with HCV. It also seems useful for avoiding adverse events, although the mechanisms of the effects of IL28B genotype on the treatment outcome are still poorly understood and are currently under investigation. Further studies will be needed.
Core tip: The exact mechanisms of the effects of interleukin-28B (IL28B) genotype on the treatment response in chronic hepatitis C patients are unclear. However, IL28B genotype is useful for the continued successful treatment of older patients infected with hepatitis C virus (HCV) and avoiding adverse events. Until the eventual availability of interferon-free regimens, it is important to determine IL28B genotype before treating HCV-infected individuals, especially in the screening of older patients.