Published online Nov 7, 2016. doi: 10.3748/wjg.v22.i41.9186
Peer-review started: June 27, 2016
First decision: August 8, 2016
Revised: August 31, 2016
Accepted: September 28, 2016
Article in press: September 28, 2016
Published online: November 7, 2016
Processing time: 132 Days and 13.1 Hours
To investigate the impact of IL28B and OAS gene polymorphisms on interferon treatment responses in children with chronic hepatitis B.
We enrolled 52 children (between the ages of 4 and 18) with hepatitis B e antigen-negative chronic hepatitis B (CHB), who were treated with pegylated interferon alfa for 48 wk. Single nucleotide polymorphisms in the OAS1 (rs1131476), OAS2 (rs1293747), OAS3 (rs2072136), OASL (rs10849829) and IL28B (rs12979860, rs12980275 and rs8099917) genes were studied to examine their associations with responses to IFN treatment in paediatric patients. We adopted two criteria for the therapeutic response, achieving an hepatitis B virus (HBV) DNA level < 2000 IU/mL and normalization of ALT activity (< 40 IU/L). To perform the analyses, we compared the patients in terms of achieving a partial response (PR) and a complete response (CR) upon measurement at the 24-wk post-treatment follow-up.
The PR and CR rates were 80.8% and 42.3%, respectively. Factors such as age, gender and liver histology had no impact on the type of response (partial or complete). A statistically significant relationship between higher baseline HBV DNA and ALT activity levels and lower rates of PR and CR was shown (P < 0.05). The allele association analysis revealed that only the IL-28B rs12979860 (C vs T) and IL28B rs12980275 (A vs G) markers significantly affected the achievement of PR (P = 0.021, OR = 3.3, 95%CI: 1.2-9.2 and P = 0.014, OR = 3.7, 95%CI: 1.3-10.1, respectively). However, in the genotype analysis, only IL-28B rs12980275 was significantly associated with PR (AA vs AG-GG, P = 0.014, OR = 10.9, 95%CI: 1.3-93.9). The association analysis for CR showed that the TT genotype of IL28B rs12979860 was present only in the no-CR group (P = 0.033) and the AA genotype of OASL rs10849829 was significantly more frequent in the no-CR group (P = 0.044, OR = 0.26, 95%CI: 0.07-0.88). The haplotype analysis revealed significant associations between PR and CR and OAS haplotype (P = 0.0002 and P = 0.001, respectively), but no association with IL28B haplotype was observed.
IL28B and OAS polymorphisms are associated with different clinical outcomes in CHB children treated with interferon.
Core tip: The limited efficacy and side effects associated with IFN treatment limit its clinical use in paediatric patients with chronic hepatitis B (CHB). Therefore, pretreatment predictors are required to identify those patients at highest risk for treatment response failure. OAS and IL28B are well-known IFN-induced antiviral pathway players; however, the impact of host-related genetic variability in the IL28B and OAS genes on response rates to IFN therapy in CHB paediatric patients has not been studied. The results of our study show an association between IL28B rs12979860, OASL rs10849829 and OAS haplotypes and final IFN-treatment response in Caucasian CHB children.