Impact of IL28B on the treatment decision in naïve and experienced patients with genotype 1 and 4 chronic hepatitis C in real-life clinical practice: A prospective multicenter cohort
| Autor: | Jean-François Cadranel, Philippe Halfon, Hacène Khiri, Iliade Investigators, Thierry Allegre, Christophe Renou, Alain Lafeuillade, Denis Ouzan, Patrick Delasalle, Guillaume Penaranda, Tarik Asselah, Nabil Haddad, Marc Bourlière |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Genotype Context (language use) Internal medicine medicine Humans Prospective Studies Prospective cohort study Hepatitis Hepatology business.industry Interleukins Mouth Mucosa Gastroenterology DNA Odds ratio Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease Surgery Cohort Female Interferons business |
| Zdroj: | Clinics and Research in Hepatology and Gastroenterology. 38:720-726 |
| ISSN: | 2210-7401 |
| Popis: | Summary Background The impact of the IL28B genotype on the real-life treatment decisions for patients infected with the hepatitis C virus (HCV) is unknown. Objective To prospectively analyze the impact of IL28B genotype in HCV genotype 1 (G1)- or 4 (G4)-infected patients using buccal epithelial cell samples in real-life clinical practices. Patients and methods From October 2011 to March 2013, 1007 CHC patients were included among 127 French clinical centers. Results The IL28B CC, CT, and TT genotype distribution was 252 (25%), 576 (57%), and 177 (18%), respectively. The treatment decisions were recorded and matched with the initial intentions for 433 patients. Multivariate analysis on intention to start treatment showed that patients with HCV G4 were less likely to be intended to be treated than HCV G1 patients (odds ratio [OR] = 0.43 [95% CI 0.19–0.97], P = 0.04); similarly HIV-HCV coinfected patients were less likely to be intended to be treated than HCV monoinfected patients (OR = 0.20 [0.09–0.41], P P = 0.004). Multivariate analysis on final decision to treat showed that Patients with F3–F4 were more likely to be treated than others (OR = 2.06 [1.26–3.38], P = 0.004). Conversely, although P -values are not significant, patients recruited in public hospitals tended to be less treated (OR = 0.65 [0.40–1.04], P = 0.069), similarly to HIV-HCV coinfected patients (OR = 0.55 [0.28–1.11], P = 0.095). Conclusion Our study showed that the IL28B genotype is used for the management of HCV-infected patients. In the context of future treatments, IL28B genotyping may remain useful if it can be used to develop individualized treatment strategies, identifying patients who can be successfully treated with shorter, simpler, or cheaper regimens. |
| Databáze: | OpenAIRE |
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