Abstract

The interleukin 28B (IL28B) rs12979860 polymorphism is associated with treatment outcome in hepatitis C virus (HCV) genotype 1 and 4 patients. Its association with the histological features of chronic hepatitis C and disease severity needs further clarifications. To assess the correlation between IL28B genotype, HCV genotype and liver biopsy findings in untreated patients.Materials and MethodsPre-treatment liver biopsies from 335 HCV Caucasian patients (59% males, age 50 years) enrolled in the MIST study were staged for fibrosis and inflammation according to the METAVIR and the Ishak scoring systems; steatosis was dichotomized as <5% or ≥5%. IL28B was typed by Taqman Single Nucleotide Polymorphism (SNP) genotyping assay. HCV genotype was 1 in 151 (45%), 2 in 99 (30%), 3 in 50 (15%) and 4 in 35 (10%) patients. IL28B genotype was CC in 117 (34%), CT in 166 (49%) and TT in 52 (15%). At univariate analysis, the IL28B CC genotype was associated with severe portal inflammation in HCV-1 patients (CC vs. CT/TT: 86% vs. 63%, p = 0.005), severe lobular inflammation in HCV-2 patients (CC vs. CT/TT: 44% vs. 23%, p = 0.03), and less fatty infiltration in HCV-1 patients (CC vs. CT/TT: 72% vs. 51%, p = 0.02). Despite the lack of any association between IL28B and fibrosis stage, in HCV-3 patients IL28B CC correlated with METAVIR F3–F4 (CC vs. CT/TT: 74% vs. 26%, p = 0.05). At multivariate analysis, the genotype CC remained associated with severe portal inflammation in HCV-1, only (Odds Ratio (OR): 95% Confidence Interval (CI): 3.24 (1.23–8.51)). IL28B genotype is associated with the histological features of chronic hepatitis C in a HCV genotype dependent manner, with CC genotype being independently associated with severe portal inflammation.

Highlights

  • The rs12979860 interleukin 28B (IL28B) gene single-nucleotide polymorphisms (SNPs) is one of the few genetic predictors proven to be of clinical utility since it identifies patients with hepatitis C infection caused by genotype 1 or 4 who undergo spontaneous [1,2] or treatment-induced [3,4,5] viral clearance [6,7,8,9]

  • Scrutinizing a large set of liver biopsies taken in patients with chronic hepatitis C of any genotype who subsequently entered a pragmatic trial of pegylated interferon (PegIFN) and ribavirin (RBV)

  • The scrutiny of a large cohort of unselected patients infected with hepatitis C virus (HCV) genotype 1 to 4 who had a pretreatment liver biopsy available to assess necro-inflammation activity, fibrosis and steatosis in the liver, did not reveal any association between IL28B genotype and these histological features of chronic hepatitis C

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Summary

Introduction

The rs12979860 interleukin 28B (IL28B) gene single-nucleotide polymorphisms (SNPs) is one of the few genetic predictors proven to be of clinical utility since it identifies patients with hepatitis C infection caused by genotype 1 or 4 who undergo spontaneous [1,2] or treatment-induced [3,4,5] viral clearance [6,7,8,9]. There is preliminary evidence for a heterogeneous distribution of histological markers of liver damage in patients with different IL28B genotypes suggesting an association between genetic control of interferon response and the natural course of chronic hepatitis C, extending our understanding of the IL28B functions beyond that of prediction of spontaneous resolution of acute hepatitis C virus HCV infection. Scrutinizing a large set of liver biopsies taken in patients with chronic hepatitis C of any genotype who subsequently entered a pragmatic trial of pegylated interferon (PegIFN) and ribavirin (RBV).

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