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World J Immunol. Nov 27, 2013; 3(3): 54-61
Published online Nov 27, 2013. doi: 10.5411/wji.v3.i3.54
Role of IL28B genotype in older hepatitis C virus-infected patients
Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Osamu Yokosuka
Tatsuo Kanda, Shingo Nakamoto, Shuang Wu, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
Author contributions: Kanda T drafted the manuscript; Kanda T, Nakamoto S, Wu S and Yokosuka O contributed to this paper.
Supported by Grant 24590955 for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology, Japan to Kanda T
Correspondence to: Tatsuo Kanda, MD, PhD, Associate Professor, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. kandat-cib@umin.ac.jp
Telephone: +81-43-2262086 Fax: +81-43-2262088
Received: July 30, 2013
Revised: September 2, 2013
Accepted: October 16, 2013
Published online: November 27, 2013
Processing time: 122 Days and 13.4 Hours
Abstract

The average age of hepatitis C virus (HCV)-infected individuals is becoming increasingly higher in Japan and steps should be taken to treat older individuals infected with HCV. Until an interferon-free regimen becomes available, peginterferon plus ribavirin will play a critical role in the treatment. The perception that older HCV-infected patients may be at higher risk than younger patients for adverse events from peginterferon plus ribavirin treatment but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials. A recent genome-wide association study revealed that interleukin-28B (IL28B) genotype closely correlates with the treatment response against HCV. The relationship of IL28B genotype with the treatment response in older HCV-infected patients is also unknown. In this review, we focused on the treatment response in older patients infected with HCV and the effects of IL28B genotype. IL28B major genotype is a useful predictor of sustained virological response in the interferon-including treatment of older patients infected with HCV. It also seems useful for avoiding adverse events, although the mechanisms of the effects of IL28B genotype on the treatment outcome are still poorly understood and are currently under investigation. Further studies will be needed.

Keywords: Hepatitis C virus; Interferon lambda 3; Interleukin-28B; Older patients; Telaprevir

Core tip: The exact mechanisms of the effects of interleukin-28B (IL28B) genotype on the treatment response in chronic hepatitis C patients are unclear. However, IL28B genotype is useful for the continued successful treatment of older patients infected with hepatitis C virus (HCV) and avoiding adverse events. Until the eventual availability of interferon-free regimens, it is important to determine IL28B genotype before treating HCV-infected individuals, especially in the screening of older patients.