The lack of consensus on the optimal timing, regimen, and duration of treatment, in patients with acute HCV infection, stimulates the research on both favorable outcome predictors, and individualized treatment regimens.
Dr Alessandra Mangia and colleagues from Italy investigated the impact of IL28B SNP rs12979860 alone or in combination with HLA class II alleles in both predicting spontaneous viral clearance and individualizing treatment strategies for patients with HCV persistence, after acute HCV exposure.
The team identified 178 patients with AHC, consecutively treated with interferon alone or in combination with ribavirin, starting within or after 48weeks from the diagnosis of AHC.
The patients were tested for IL28B SNPs and HLA class II alleles.
The team reported that spontaneous viral clearance was achieved in 28% of 169 patients available for genetic testing.
|Spontaneous viral clearance was achieved in 28% of patients|
|Journal of Hepatology|
Factors associated with HCV elimination were jaundice and IL28B CC, but not HLA alleles.
The researchers performed CT/TT in patients without jaundice.
The team found that NPV for virus persistence was 98%.
In patients with IL28B CT/TT, starting treatment 48 weeks after the onset was significantly associated with lower rates of response.
By contrast, no significant differences in the rate of sustained virological response were observed for CC carriers who started treatment later.
Dr Mangia's comments, "In patients with acute HCV hepatitis, lack of viral clearance may be predicted by absence of jaundice and IL28B CT/TT genotype; in patients with these characteristics, treatment needs to be started immediately."