August 15, 2013

Sex, genotype, and IL28B pattern predict spontaneous HCV clearance

blogger_HCVWomen, people with hepatitis C virus (HCV) genotype 1, and those with a favorable IL28B gene pattern are more likely to spontaneously clear HCV without treatment, while those with unfavorable patterns are more likely to benefit from earlier therapy, according to 2 recent studies.

Approximately 20%-40% of people initially infected with HCV will go on to clear the virus without treatment, while the rest will develop chronic infection lasting longer than 6 months.

Over years or decades, chronic hepatitis C can lead to severe liver disease including cirrhosis and liver cancer.

Predictors of Spontaneous Clearance

As described in the August 2, 2013, online edition of Hepatology, Jason Grebely from the Kirby Institute at the University of New South Wales in Sydney and colleagues aimed to learn more about the time course and factors associated with spontaneous HCV clearance.

The researchers looked at data from an international collaboration of 9 prospective cohorts evaluating outcomes after acute HCV infection in Australia, Canada, Europe, and the U.S. The analysis included 632 participants with acute hepatitis C. About two-thirds were men, about 80% were white, and most had a history of injection drug use; 5% were coinfected with HIV.

Just under half of participants (47%) had HCV genotype 1 and a similar proportion (49%) had the IL28B CC gene pattern (single nucleotide polymorphism rs12979860). Genotype 1 HCV is more difficult to treat than genotypes 2 or 3, while the IL28B CC pattern is associated with better response to interferon-based therapy than the CT or TT patterns.

The main endpoint was spontaneous HCV clearance, defined as 2 consecutive tests at least 4 weeks apart showing undetectable HCV RNA.

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