Department of Infectious Diseases, University of Gothenburg, Sweden.
J Infect Dis. 2011 Jun 15;203(12):1748-52. doi: 10.1093/infdis/jir193.
Single-nucleotide polymorphisms upstream of the interleukin 28B (interferon λ3) gene (IL28B) strongly influence treatment efficacy in patients carrying hepatitis C virus (HCV) of genotype 1. In patients receiving 12 or 24 weeks of interferon-ribavirin therapy for infection with genotype 2 or 3 (n = 341), we found that rs12979860 strikingly determined the first phase of viral elimination (P < .001). In patients treated for 24 weeks, rs12979860 also predicted the rate of sustained virologic response (P = .02), especially among those with high baseline HCV RNA levels (P = .002) or older than 45 years (P = .01). Patients carrying CC(rs12979860) had higher baseline HCV RNA levels (P < .001) and did not, when treated for 12 weeks, achieve sustained virologic response more often than those carrying CT(rs1297986) or TT(rs1297986). The results indicate that IL28B gene testing may identify patients carrying genotype 2 or 3 who could benefit from extended treatment.
白细胞介素 28B（干扰素 λ3）基因上游的单核苷酸多态性（IL28B）强烈影响携带基因型 1 丙型肝炎病毒（HCV）患者的治疗效果。在接受基因型 2 或 3 感染的 12 或 24 周干扰素-利巴韦林治疗的患者中（n = 341），我们发现 rs12979860 显著决定了病毒消除的第一阶段（P <.001）。在接受 24 周治疗的患者中，rs12979860 也预测了持续病毒学应答率（P =.02），尤其是那些基线 HCV RNA 水平较高（P =.002）或年龄大于 45 岁的患者（P =.01）。携带 CC(rs12979860)的患者基线 HCV RNA 水平更高（P <.001），并且在接受 12 周治疗时，与携带 CT(rs1297986)或 TT(rs1297986)的患者相比，持续病毒学应答的发生率更低。结果表明，IL28B 基因检测可能可以识别出基因型 2 或 3 的患者，这些患者可能受益于延长治疗。
