Stättermayer Albert Friedrich, Ferenci Peter
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Curr Opin Virol. 2015 Oct;14:50-5. doi: 10.1016/j.coviro.2015.07.011. Epub 2015 Aug 15.
Genetic factors play a major role for treatment response and disease progression of chronic hepatitis B (HBV) and C virus (HCV) infection. In 2009 a genome-wide association study (GWAS) identified a single nucleotide polymorphism near the IL28B gene that was associated with treatment-induced viral clearance in chronic HCV infection treated with pegylated interferon-α (PEG-IFN) and ribavirin (RBV). Further, another GWAS found an association between IL28B genotype and spontaneous viral clearance in acute HCV infection. The effect on sustained viral response (SVR) could also be observed in patients receiving a triple-therapy with a direct antiviral agent (DAA) combined with PEG-IFN/RBV. In the era of all-oral interferon-free treatment regimens with the combination of different DAAs-with SVR rates exceeding 90%-the effect of IL28B was blunt. In contrast, in HBV several retrospective studies yielded conflicting results of the association of IL28B with PEG-IFN-induced treatment response.
遗传因素在慢性乙型肝炎(HBV)和丙型肝炎病毒(HCV)感染的治疗反应及疾病进展中起着主要作用。2009年,一项全基因组关联研究(GWAS)在IL28B基因附近发现了一个单核苷酸多态性,该多态性与聚乙二醇化干扰素-α(PEG-IFN)联合利巴韦林(RBV)治疗的慢性HCV感染中治疗诱导的病毒清除相关。此外,另一项GWAS发现IL28B基因型与急性HCV感染中的自发病毒清除之间存在关联。在接受直接抗病毒药物(DAA)联合PEG-IFN/RBV的三联疗法的患者中,也能观察到对持续病毒学应答(SVR)的影响。在不同DAA联合使用的无干扰素全口服治疗方案时代——SVR率超过90%——IL28B的作用不明显。相比之下,在HBV方面,几项回顾性研究对于IL28B与PEG-IFN诱导的治疗反应之间的关联得出了相互矛盾的结果。