Importance of HLA-B in the sustained virological response in patients with chronic hepatitis C treated with peg-IFN and ribavirin
K.J. Ibrahim1, E. Sigaudo1, A. D’Avolio2, M. Fadda3, P. Caviglia1, A. Smedile1, G. Di Perri2, M. Rizzetto1, A. Ciancio1
1AOU San Giovani Battista di Torino – SCDU GastroEpatologia, Università di Torino; 2Ospedale Amedeo di Savoia- Clinica Malattie Infettive; 3 AOUSan Giovani Battista di Torino – SC Dietetica e Nutizione Clinica
Background: The importance of HLA-system in the HCV treatment response, has recently been emphasized. Several studies have shown a significative correlation between therapy success and alleles HLA-B*12, B*44, DRB1*04 and DRB1*07. Interleukin 28B (IL28B) genotype predicts treatment-induced and spontaneous clearance. Our study aimed to evaluate HLA-B and HLA-DRB1 role and clinical importance in the response to therapeutic treatment with PegIFNα2a/2b and
Ribavirin in patients with chronic hepatitis C.
Patients and Methods: One hundred and eighty-one patients (M/F 109/72 [genotype 1a = 4%, 1b = 55%, 2a/2c = 18%, 3a = 18% and 4 = 4%] with chronic HCV hepatitis, underwent antiviral
treatment [PegIFNα2a 180 μg/week (70%) or PegIFNα2b 15 μg/kg/week (30%)+ ribavirin 1000-1200 mg/die)] and included in the study. At baseline, all patients were evaluated for HLA-B and DRB1 allelles as well as for IL28 polimorphisms.
Results: Among studied population, 52% (n=94) achieved a sustained virological response (SVR), 32% (n=58) were non-responder, while 16% (n=29) relapsers. The occurrence of SVR,
indipendently of viral genotype, was strongly correlated with presence of HLA-B38 (p=0.03) and weakly with B*08 (p=0.06), while failure to treatment was weakly associated with HLA DRB1* (p=006) and DRB1*07 (p=007). Moreover our analysis confirm that HCV genotype non-1, HCV RNA clearance at week 12 and IL28 polymorphism (rs12979860) CC were positive predictors of SVR.
Conclusions: Our study confirms that host genetic factors may be associated with a response to antiviral therapy. The significative association between HLA-B*38 and SVR as well IL28
polimorphisms demonstrate that both genetic factors may be useful in the treatment evaluation and chronic HCV hepatitis management
