Araştırma Makalesi
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IL28B polymorphism predict the response to chronic hepatitis C treatment

Yıl 2018, , 281 - 285, 28.09.2018
https://doi.org/10.31362/patd.428482

Öz

Purpose: Hepatitis
C is an important medical problem which causes chronic liver disease. 170
million people are believed to be infected throughout the world. While
spontaneous hepatitis C virus (HCV) clearance occurs in almost 30 % of patients
with hepatitis C, it becomes chronic in 70 % which may progress to cirrhosis or
hepatocellular carcinoma (HCC). In recent years, IL28B polymorphism on
chromosome 19q13 has been suggested as the most important predictor among the
host factors for sustained virologic response (SVR). In the present study, we
aimed to evaluate the effect of IL28B gene polymorphism on conventional
treatment response.

Materials
and methods:
Totally
95 patients treated with a combination of peginterferon and ribavirin during 48
weeks were included the study. Age, gender, AST and ALT levels, insulin and
fasting glucose levels, BMI, fibrosis levels on liver biopsy and
0-4-12-24-48-72-week HCV RNA values were recorded.

Results: In the study
group of 95 HCV-infected patients, the mean age was 52.4±11 years. SVR was
observed in 54
(%56.8) of
patients at the follow up. Demographical and laboratory variables were similar
in SVR and non-SVR groups. IL28B SNP rs12979860 was positive in CC 26 (47.2 %),
CT 25 (45.4%) and TT 4 (7.2 %) patients with SVR group and in CC 4 (10 %), CT
23 (57.5 %), TT 13 (32.5 %) patients with non-SVR group.







Conclusion: SVR was
achieved more likely in HCV genotype 1 rs12979860, and treatment decision may
be changed based on the degree of liver disorder. In this regard, new studies
involving larger patient population from our country are needed.    



Kaynakça

  • Mohamed AA, Elbedewy TA, El-Serafy M, El-Toukhy N, Ahmed W, Ali El Din Z. Hepatitis C virus: A global view. World J Hepatol. 2015;7:2676–2680.
  • Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect.2015;21:1020-1026.
  • Ge D, Fellay J, Thompson AJ, Simon JS, Shianna KV, Urban TJ, et al. Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature. 2009 17;461:399-401.
  • Altuglu I, Soyler I, Ozacar T, Erensoy S. Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in Western Turkey. Int J Infect Dis. 2008 ;12:239-244.
  • Suppiah V, Moldovan M, Ahlenstiel G, Berg T, Weltman M, Abate ML, et al. IL28B is associated with response to chronic hepatitis C interferon-alpha and ribavirin therapy. Nat Genet. 2009;41:1100-1104.
  • Tanaka Y, Nishida N, Sugiyama M, Kurosaki M, Matsuura K, Sakamoto N, et al. Genome-wide association of IL28B with response to pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C. Nat Genet. 2009;41:1105-1109.
  • Thompson AJ, Muir AJ, Sulkowski MS, Ge D, Fellay J, Shianna KV, et al. Interleukin-28B polymorphism improves viral kinetics and is the strongest pretreatment predictor of sustained virologic response in genotype 1 hepatitis C virus. Gastroenterology. 2010;139:120-129.
  • Yu JW, Wang GQ, Sun LJ, Li XG, Li SC. Predictive value of rapid virological response and early virological response on sustained virological response in HCV patients treated with pegylated interferon alpha-2a and ribavirin. J Gastroenterol Hepatol. 2007 ;22:832-836.
  • Jensen DM, Morgan TR, Marcellin P, Pockros PJ, Reddy KR, Hadziyannis SJ, et al. Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon alpha-2a (40 kd)/ribavirin therapy. Hepatology. 2006;43:954-60.
  • Thomas DL, Thio CL, Martin MP, Qi Y, Ge D, O'Huigin C, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature. 2009;461(7265):798-801.
  • Rauch A, Kutalik Z, Descombes P, Cai T, Di Iulio J, Mueller T, et al. Genetic variation in IL28B is associated with chronic hepatitis C and treatment failure: a genome-wide association study. Gastroenterology. 2010;138:1338-1345.
  • Stattermayer AF, Stauber R, Hofer H, Rutter K, Beinhardt S, Scherzer TM, et al. Impact of IL28B genotype on the early and sustained virologic response in treatment-naive patients with chronic hepatitis C. Clin Gastroenterol Hepatol. 2011;9:344-350.
  • Echeverría N, Chiodi D, López P, Sanchez Ciceron A, Angulo J, López-Lastra M, et al. IL28B gene polymorphism rs12979860, but not rs8099917, contributes to the occurrence of chronic HCV infection in Uruguayan patients.Virol J. 2018;15:40.
  • Ramos JA, Ramos AL, Hoffmann L, Perez Rde M, Coelho HS, Urmenyi TP, et al. A single nucleotide polymorphism, rs129679860, in the IL28B locus is associated with the viral kinetics and a sustained virological response in a chronic, monoinfected hepatitis C virus genotype-1 Brazilian population treated with pegylated interferon-ribavirin. Mem Inst Oswaldo Cruz. 2012;107:888-892.
  • Świątek-Kościelna B, Kałużna E, Strauss E, Nowak J, Bereszyńska I, Gowin E, et al. Prevalence of IFNL3 rs4803217 single nucleotide polymorphism and clinical course of chronic hepatitis C.World J Gastroenterol. 2017;23:3815-3824.

Kronik hepatit C tedavisine yanıtı tahmin etmede IL28B gen polimorfizmi

Yıl 2018, , 281 - 285, 28.09.2018
https://doi.org/10.31362/patd.428482

Öz

Amaç: Hepatit C, kronik karaciğer hastalığına neden olan
büyük bir sağlık sorunudur. Dünya’da 170 milyon insanın enfekte olduğu
düşünülmektedir.
Hepatit C’li hastaların
yaklaşık % 30’unda spontan viral klirens meydana gelirken, % 70’inde hastalık
kronikleşmekte, bir kısmında siroz ve hepatosellüler kanser gelişebilmektedir.
Konak faktörleri içinde kalıcı viral yanıtın en iyi belirleyicisi, son yıllarda
ortaya konan kromozom 19q13 üzerindeki IL28 B polimorfizmidir.
Çalışmadaki amacımız bölgemizdeki
hasta populasyonunda IL28B gen polimorfizminin tedaviye yanıta olan etkisini
ortaya koymaktır.

Gereç ve yöntem: Çalışmaya 48 haftalık peginterferon ve
ribavirin tedavisi ve sonrasındaki 24. haftada kontrole gelen 95 hasta alındı.
Hastaların tedavi öncesi yaş, cinsiyet, AST, ALT değerleri, insülin ve açlık
glukozu, karaciğer biyopsisinde fibrozis düzeyleri,- 0-4-12-24-48-72. hafta HCV
RNA değerleri kaydedildi.

Bulgular: Hastaların yaş ortalaması 52,4±11 idi. Çalışma
sonunda hastaların 54’ünde (%56.8) kalıcı viral yanıt gözlendi. Tedaviye yanıta
etki eden demografik ve laboratuvar özellikleri kalıcı viral yanıt ve kalıcı olmayan
viral yanıt gruplarında benzerdi. Kalıcı viral yanıt olan hastalarda IL 28B SNP
rs12979860 polimorfizmine bakıldığında; CC 26 (% 47.2), CT 25 (% 45.4), TT 4 (%
7.2) hastada saptandı. Kalıcı viral yanıt olmayan hastalarda IL 28B SNP
rs12979860 polimorfizmi; CC 4 ( % 10) ,CT 23 (% 57.5), TT 13 (% 32.5) hastada
saptandı.







Sonuç:
HCV genotip 1
rs12979860 CC genotipte kalıcı viral yanıt oranının yüksek olması nedeniyle
karaciğer hastalığının şiddetine dayalı tedavi kararını değiştirebilir.
Bu
konuda ülkemizde daha büyük hasta populasyonlarını içeren çalışmalara ihtiyaç
vardır.

Kaynakça

  • Mohamed AA, Elbedewy TA, El-Serafy M, El-Toukhy N, Ahmed W, Ali El Din Z. Hepatitis C virus: A global view. World J Hepatol. 2015;7:2676–2680.
  • Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect.2015;21:1020-1026.
  • Ge D, Fellay J, Thompson AJ, Simon JS, Shianna KV, Urban TJ, et al. Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature. 2009 17;461:399-401.
  • Altuglu I, Soyler I, Ozacar T, Erensoy S. Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in Western Turkey. Int J Infect Dis. 2008 ;12:239-244.
  • Suppiah V, Moldovan M, Ahlenstiel G, Berg T, Weltman M, Abate ML, et al. IL28B is associated with response to chronic hepatitis C interferon-alpha and ribavirin therapy. Nat Genet. 2009;41:1100-1104.
  • Tanaka Y, Nishida N, Sugiyama M, Kurosaki M, Matsuura K, Sakamoto N, et al. Genome-wide association of IL28B with response to pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C. Nat Genet. 2009;41:1105-1109.
  • Thompson AJ, Muir AJ, Sulkowski MS, Ge D, Fellay J, Shianna KV, et al. Interleukin-28B polymorphism improves viral kinetics and is the strongest pretreatment predictor of sustained virologic response in genotype 1 hepatitis C virus. Gastroenterology. 2010;139:120-129.
  • Yu JW, Wang GQ, Sun LJ, Li XG, Li SC. Predictive value of rapid virological response and early virological response on sustained virological response in HCV patients treated with pegylated interferon alpha-2a and ribavirin. J Gastroenterol Hepatol. 2007 ;22:832-836.
  • Jensen DM, Morgan TR, Marcellin P, Pockros PJ, Reddy KR, Hadziyannis SJ, et al. Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon alpha-2a (40 kd)/ribavirin therapy. Hepatology. 2006;43:954-60.
  • Thomas DL, Thio CL, Martin MP, Qi Y, Ge D, O'Huigin C, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature. 2009;461(7265):798-801.
  • Rauch A, Kutalik Z, Descombes P, Cai T, Di Iulio J, Mueller T, et al. Genetic variation in IL28B is associated with chronic hepatitis C and treatment failure: a genome-wide association study. Gastroenterology. 2010;138:1338-1345.
  • Stattermayer AF, Stauber R, Hofer H, Rutter K, Beinhardt S, Scherzer TM, et al. Impact of IL28B genotype on the early and sustained virologic response in treatment-naive patients with chronic hepatitis C. Clin Gastroenterol Hepatol. 2011;9:344-350.
  • Echeverría N, Chiodi D, López P, Sanchez Ciceron A, Angulo J, López-Lastra M, et al. IL28B gene polymorphism rs12979860, but not rs8099917, contributes to the occurrence of chronic HCV infection in Uruguayan patients.Virol J. 2018;15:40.
  • Ramos JA, Ramos AL, Hoffmann L, Perez Rde M, Coelho HS, Urmenyi TP, et al. A single nucleotide polymorphism, rs129679860, in the IL28B locus is associated with the viral kinetics and a sustained virological response in a chronic, monoinfected hepatitis C virus genotype-1 Brazilian population treated with pegylated interferon-ribavirin. Mem Inst Oswaldo Cruz. 2012;107:888-892.
  • Świątek-Kościelna B, Kałużna E, Strauss E, Nowak J, Bereszyńska I, Gowin E, et al. Prevalence of IFNL3 rs4803217 single nucleotide polymorphism and clinical course of chronic hepatitis C.World J Gastroenterol. 2017;23:3815-3824.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Altay Kandemir 0000-0002-2918-3811

Belkıs Ünsal Bu kişi benim

Yayımlanma Tarihi 28 Eylül 2018
Gönderilme Tarihi 30 Mayıs 2018
Kabul Tarihi 5 Temmuz 2018
Yayımlandığı Sayı Yıl 2018

Kaynak Göster

AMA Kandemir A, Ünsal B. IL28B polymorphism predict the response to chronic hepatitis C treatment. Pam Tıp Derg. Eylül 2018;11(3):281-285. doi:10.31362/patd.428482
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