IL28B polymorphism may guide pegylated interferon plus ribavirin therapy even after curative treatment for hepatitis C virus-related hepatocellular carcinoma

J Viral Hepat. 2011 Oct;18(10):e550-60. doi: 10.1111/j.1365-2893.2011.01468.x. Epub 2011 May 23.

Abstract

The present study was designed to determine the predictive factors for the viral response to pegylated interferon-alpha plus ribavirin combination therapy (PEGIFN/RBV) administered after curative treatment for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). The study group was 78 patients treated between January 2005 and January 2009. The sustained viral response (SVR) rate was 25.8% (15/58) in patients infected with HCV-genotype 1 and 55.0% (11/20) in those with genotype 2. Among the 78 patients, 32 (41.0%) could not complete the treatment protocol, and this was because of HCC recurrence in 17 (53%) of them. Multivariate analysis identified partial early viral response (pEVR) as the only independent determinant of SVR [odds ratio (OR) 14.73, P = 0.013] for patients with genotype 1. Multivariate analysis identified male gender (OR 8.72, P = 0.001) and interleukin-28B (IL-28B) genotype (rs8099917) TT (OR 7.93, P = 0.007) as independent predictors of pEVR. Multivariate analysis also identified IL-28B genotype GG+TG (OR 14.1, P = 0.021) and α-fetoprotein >30 (OR 5.4, P = 0.031) as independent predictors of null response. Patients with SVR showed a better survival rate than those without SVR (P = 0.034). The second HCC recurrence rate tended to be lower in patients with SVR than in those without SVR (P = 0.054). With regard to the prognosis of patients with SVR, it is desirable to achieve SVR with interferon therapy even when administered after HCC treatment. IL-28B genotype is a potentially useful marker for the response to PEGIFN/RBV therapy administered after curative treatment of HCV-related HCC.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiviral Agents / administration & dosage*
  • Carcinoma, Hepatocellular / drug therapy*
  • Female
  • Genotype
  • Hepacivirus / classification
  • Hepacivirus / genetics
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Humans
  • Interferons / administration & dosage*
  • Interleukins / genetics*
  • Male
  • Middle Aged
  • Polymorphism, Genetic*
  • Recurrence
  • Ribavirin / administration & dosage*
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antiviral Agents
  • interferon-lambda, human
  • Interleukins
  • Ribavirin
  • Interferons