Abstract
Recent discoveries in the field of genomics (IL28B genotyping) and therapeutics (direct acting antiviral agents [DAA]) have substantially increased the rate of sustained virological response (SVR) in HCV-infected patients. IL28B genotyping has been shown to be the strongest predictor of SVR in treatment-naive HCV-genotype 1 infected patients; achieving 2-3-fold higher chance of SVR in case of patients with good response genotype, and thereby aids in initiation of personalized therapy regimens. Additionally, the introduction of DAA compounds has significantly increased SVR in case of both treatment-naive patients and in non-responders (treated with pegylated interferon and ribavirin). This scientific development has raised a question over the clinical utility of IL28B genotyping in the era of DAA. Data from primary studies, clinical trials and cost-effective comparative analysis of various combination of treatment regimens indicate that IL28B genotyping would permit initiation of less expensive non-DAA based treatment regimens; and also, DAAs are often known to be associated with adverse side-effects like anemia.
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