Abstract
AimTo evaluate the influence of the presence of the killer cell immunoglobulin-like receptor (KIR) 3DS1 on HCV treatment response in HIV/HCV genotype 1 co-infected patientsMethodsHIV/HCV co-infected patients were included. KIR3DS1, their specific HLA-B ligands and IL28B gene were genotyped. Reductions of plasma HCV RNA levels between baseline and week 1, week 2 and week 4 were analyzed for IL28B genotype and KIR3DS1 (HLA Bw4 or Bw6). Rapid and sustained virological response (RVR and SVR) rates were also analyzed.ResultsSixty HIV/HCV genotype 1 co-infected patients were included. Patients with KIR3DS1 and Bw4 had higher rates of HCV viral decline than those who were not carriers of KIR3DS1 (week1: p = 0.01; week2: p = 0.038; week 4: p = 0.03). Patients carrying KIR3DS1/Bw4 had higher rates of RVR and SVR than those who did not carry KIR3DS1 (RVR: 46.15% versus 17.02%, p = 0.012; SVR: 63.6% versus 13 26.5%, p = 0.031). With respect to patients carrying the IL28B-CC genotype, those with KIR3DS1/Bw4 had greater rates of HCV viral clearance (week1: p<0.001; week2: p = 0.01; week 4: p = 0.02), RVR (p = 0.015) and SVR (p = 0.029) than those not carrying KIR3DS1.ConclusionOur results show that the KIR3DS1 genotype has a positive effect on HCV viral clearance during the first weeks of Peg-IFN/RBV treatment in HCV/HCV co-infected patients bearing genotype 1, and higher RVR and SVR rates.
Highlights
In recent years, the interleukin 28B (IL28B) rs12979860 polymorphism has been identified as the best baseline predictor of sustained virological response (SVR) in both hepatitis C virus (HCV) monoinfected and human immunodeficiency virus (HIV) co-infected patients bearing genotype 1 [1,2]
Baseline patient characteristics Sixty HIV/HCV genotype 1 co-infected patients were included in this prospective study
Baseline characteristics are shown in Table 1. 21 (35%) patients carried the IL28B-CC genotype and 39 (65%), the IL28B non-CC genotype
Summary
The IL28B rs12979860 polymorphism has been identified as the best baseline predictor of sustained virological response (SVR) in both HCV monoinfected and HIV co-infected patients bearing genotype 1 [1,2]. We do know that its beneficial impact on HCV viral clearance is due to a greater and more rapid HCV viral decline in the first weeks following start of treatment with pegylated-interferon (Peg-IFN) plus ribavirin (PegIFN/RBV) [3,4]. It has been hypothesized that this beneficial impact is due to the fact that patients with the IL28B-CC genotype are more susceptible to exogenous IFN administration than those with the IL28B non-CC genotype [5]. The association between interferon-stimulated gene (ISG) expression and the IL28B genotype is a controversial point [6]. This suggests that there may be other factors that modify the effect of the IL28B genotype on HCV treatment response [7,8]
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