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Meta‐analysis: IL ‐28 B genotype and sustained viral clearance in HCV genotype 1 patients
Author(s) -
Rangnekar A. S.,
Fontana R. J.
Publication year - 2012
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2012.05145.x
Subject(s) - genotype , medicine , odds ratio , ribavirin , gastroenterology , population , immunology , hepatitis c virus , gene , biology , virus , genetics , environmental health
Summary Background Polymorphisms in the IL ‐28 B region are a strong predictor of sustained virologic response ( SVR ) in individual studies of HCV genotype 1 patients receiving peginterferon (peg IFN ) and ribavirin. Aim To obtain a pooled odds ratio ( OR ) of SVR in patients of varying race with the favourable IL ‐28 B genotype compared to those with the unfavourable genotype. Methods A literature search was conducted using online databases and a review of conference abstracts. A random effects meta‐analysis was performed and study heterogeneity and publication bias were assessed. Results There were 21 individual studies of HCV genotype 1 patients of varying ethnicity treated with peg IFN and ribavirin. The pooled prevalence of the favourable IL ‐28 B genotype varied by race (73% vs. 41% vs. 13% in 2612 Asians, 3110 Caucasians and 452 African‐Americans, respectively, P < 0.001). However, the strength of association of the IL ‐28 B genotype with SVR was similar in all three racial groups (Caucasians: odds ratio ( OR ) 3.88, 2.75–5.49, African‐Americans: OR 4.63, 2.52–8.50 and Asians OR 5.66, 3.99–8.02, all P < 0.001). The IL ‐28 B genotype was also associated with SVR in 263 HIV / HCV co‐infected Caucasians ( OR 5.49, 3.02–9.96, P < 0.001). Study quality score and anti‐viral treatment regimen did not impact the strength of the association in patient subgroups nor in the pooled population. Conclusions IL ‐28 B genotype is significantly associated with SVR in HCV genotype 1 patients of varying race, as well as in HIV co‐infected patients, receiving peg IFN and ribavirin. IL ‐28 B testing in conjunction with other pre‐treatment parameters may prove useful in counselling HCV patients.