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

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 pat...

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Veröffentlicht in:Journal of viral hepatitis 2011-10, Vol.18 (10), p.e550-e560
Hauptverfasser: Kawaoka, T., Aikata, H., Takaki, S., Hiramatsu, A., Waki, K., Hiraga, N., Miki, D., Tsuge, M., Imamura, M., Kawakami, Y., Takahashi, S., Ochi, H., Tashiro, H., Ohdan, H., Chayama, K.
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Sprache:eng
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Zusammenfassung: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.
ISSN:1352-0504
1365-2893
DOI:10.1111/j.1365-2893.2011.01468.x