The Role of Pharmacogenetics in the Treatment of Chronic Hepatitis C Infection

Abstract

Hepatitis C virus (HCV) chronically infects 170 million people worldwide. Until recently, combination therapy with peginterferon‐α (pegIFN) and ribavirin (RBV) has been the standard of care. However, for many patients, especially those infected with the most common HCV genotype 1 (HCV‐1), this treatment has resulted in unsatisfactory treatment response rates. Many clinical factors, including pharmacogenetics, influence the treatment response rate. Genetic variation in the interleukin 28B (IL28B) gene is the major determinant of treatment response, a finding that has been replicated in multiple independent cohorts. This review focuses on the association between pharmacogenetics and conventional pegIFN/RBV therapy in patients infected with HCV non–genotype 1; patients reinfected with HCV after liver transplantation; and patients coinfected with HCV and human immunodeficiency virus. We also review the pharmacogenetic data for boceprevir and telaprevir triple therapy in patients with HCV‐1 infection, as well as viral genomic polymorphisms and genetic variants that may protect against anemia. Pharmacogenetic information offers a personalized medicine approach to help clinicians and patients make better informed decisions to maximize response and minimize toxicity for the treatment of chronic HCV infection.

Interleukin-28B Polymorphism is a Pharmacogenetic Predictor during Sofosbuvir Plus Pegylated Interferon and Ribavirin Therapy for Chronic Hepatitis C Egyptian Patients

“…Recently, pharmacogenomic is related to drug response and precision medicine [39]. Precision medicine allows doctors and researchers to predict treatment strategies for health care improvement.…”

“…Besides, Pharmacogenomic information offers a personalized medicine approach to help clinicians and patients make better informed decisions to maximize response and minimize toxicity for the treatment of chronic HCV infection [39].…”

Pharmacogenomic Testing in the Era of Patient-Tailored HCV Treatment

“…Due to that fact, the task to produce pan-genotypic drugs has been very demanding [8]. Accordingly, the response of HCV infection to treatment regimens and its duration can vary depending on viral genotype [9].…”

“…As previously mentioned, combination of PegIFN and RBV had been the standard-of-care for patients with chronic hepatitis C for more than a decade [9]. Notwithstanding, many patients still did not respond to therapy and could not achieve SVR or developed adverse events [54].…”

“…Notwithstanding, many patients still did not respond to therapy and could not achieve SVR or developed adverse events [54]. It has been noticed that many clinical factors, including pharmacogenetics, could influence the treatment response rate [9]. Both virological factors (such as HCV genotype, quasispecies diversity, and baseline viremia) and host factors (age, gender, race-ethnicity, fibrosis stage, obesity, hepatic steatosis, low-density lipoprotein cholesterol, insulin resistance, and genetic variances) played an important role in predicting the natural course of hepatitis C and IFN response to therapy [7,[55][56][57].…”