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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Limited Use of Interleukin 28B in the Setting of Response-Guided Treatment with Detailed On-Treatment Virological Monitoring
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Limited Use of Interleukin 28B in the Setting of Response-Guided Treatment with Detailed On-Treatment Virological Monitoring

机译：在详细治疗中病毒学监测的应答指导治疗中限制使用白细胞介素28B

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A single-nucleotide polymorphism upstream of the interleukin-28B {IL28B) gene is associated with pegylated interferon-alfa-induced viral clearance in hepatitis C virus (HCV) genotype 1 patients. Using a well-characterized cohort of patients randomized to standard versus response-guided therapy, we studied whether the favorable CC type allows shortening of treatment duration. Association with viral kinetics, sustained viral response (SVR), and predictors of response were also analyzed. In the original study, 696 patients were randomized to either standard or variable therapy of 24, 48, or 72 weeks according to first undetectable HCV RNA. Association between IL28B determined by genotyping rs12979860 and end of treatment response and SVR by treatment arm was tested; baseline predictors of response were analyzed using multiple logistic regression. A total of 454 patients were evaluated. The frequency of IL28B type was CC = 29%, CT = 53%, TT = 18%. CC type was strongly associated with rapid virological response (RVR) as well as higher rates of week 8 and week 12 response. CC type was associated with SVR in both arms. In patients with RVR, SVR was high and IL28B type was not associated with SVR. In RVR patients, there was no significant difference in SVR or relapse rates after 24 or 48 weeks by IL28B type. Among non-RVR patients, CC type was associated with SVR at a higher rate than CT/TT, both in standard and variable analysis. However, when week 8 and week 12 responders were considered separately, IL28B type was no longer predictive of SVR. Few CC patients remained viremic beyond week 8 to allow the analysis of relationships between IL28B type and extended treatment. Conclusion: In HCV-1 patients, the favorable CC type strongly predicted higher rates of on-treatment virological milestones and SVR. However, achievement of on-treatment virological milestones was the critical factor in determining outcome. IL28B type appeared to have limited potential for response-guide...
机译：白细胞介素28B（IL28B）基因上游的单核苷酸多态性与聚乙二醇化干扰素-α诱导的丙型肝炎病毒（HCV）基因型1患者病毒清除率相关。使用特征明确的队列，随机分组接受标准疗法和反应指导疗法，我们研究了有利的CC类型是否可以缩短治疗时间。还分析了与病毒动力学，持续病毒应答（SVR）和应答预测因子的关联。在最初的研究中，根据第一个无法检测到的HCV RNA，将696例患者随机分为24、48或72周的标准或可变疗法。测试了通过rs12979860基因分型确定的IL28B与治疗反应结束和治疗组的SVR之间的关联;使用多元逻辑回归分析了基线反应的预测指标。总共对454名患者进行了评估。 IL28B型的频率为CC = 29％，CT = 53％，TT = 18％。 CC类型与快速病毒学应答（RVR）以及第8周和第12周的较高发生率密切相关。 CC类型与SVR都相关。在RVR患者中，SVR较高，IL28B型与SVR不相关。在RVR患者中，IL28B类型在24周或48周后SVR或复发率无显着差异。在非RVR患者中，无论在标准分析还是变量分析中，CC型与SVR相关的发生率均高于CT / TT。但是，当分别考虑第8周和第12周的反应者时，IL28B类型不再预测SVR。很少有CC患者在第8周后仍保持病毒血症，从而可以分析IL28B类型与延长治疗之间的关系。结论：在HCV-1患者中，良好的CC型强烈预测治疗中病毒学里程碑事件和SVR的发生率较高。然而，治疗中病毒学里程碑的实现是决定结果的关键因素。 IL28B型似乎对应答指导的潜力有限。

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