CP-066 Interleukin-28B polymophism as a predictor of response to telaprevir-based regimens in patients with hepatitis C virus genotype 1 infection

Abstract

Background Interleukin-28B genetic polymorphism is a key predictor of response to peginterferon-ribavirin treatment in hepatitis C virus (HCV) genotype 1 infection (HCVg1i), CC interleukin-28B genotype (IL28Bg) being highly predictive of efficacy. There is a range of genotypes as well as responses to treatment, for example see the REALISE study . Main genotypes are IL28Bg CT, CC and TT. Purpose To assess the role of IL28Bg as a predictor of response in HCVg1i patients treated with telaprevir-based treatment. Materials and methods Retrospective study of patients treated with peginterferon-ribavirin-telaprevir. Demographic and pathological data, response at 4 and 12 weeks (HCV-RNA <1000) and at 24, 36, 48 weeks of treatment (HCV-RNA undetectable), sustained virological response 12 weeks after treatment (SVR12), adverse effects and discontinuation were collected in an Access database and analysed with SPSS vs12. Results 73 patients (53 male), median age of 51 (34–76) years, 63.4% genotype 1b, 87.7% mono-infected, 68.5% pretreated (mainly relapsers 60%), and 56.2% fibrosis F3-F4. 65.8% were IL28Bg CT, 19.2% CC, 15.1% TT. 32.9% discontinued treatment. Among IL28Bg groups no difference was found either in baseline data or in response at 4,12, 24, 36 and 48 weeks of treatment and SVR12, but a lower response in TT individuals was observed in weeks 36 and 48 (85.7% vs. 100% in CT and CC) and lower SVR12 with a virological failure in TT (33.3%) and CT (12.5%), not being observed in CC. Anaemia (haemoglobin level <10 g/dL) was more frequent in CC (50%) nevertheless significant differences were not observed. There was no difference in cutaneous rash. Within each group, discontinuation was higher in CT (35.4%) and CC (35.7%) being mainly due to virological failure (52.9%) and adverse effects (60%), respectively. Conclusions IL28Bg seemed to show a very good SVR12 in the CC group, an increase in virological failure being observed in CT and TT. Published studies suggest that the IL28B genotype has a limited impact on sustained virological response (SVR) rates with telaprevir-based treatment, achieving an improvement in all IL28B genotypes. In our study SVR12 might be influenced by IL28Bg. Further SVR data is needed. No conflict of interest.