Background Recent marketing authorizations for the first protease inhibitors for hepatitis C virus (HCV) have changed the management of chronic hepatitis C patients. However, it should be noted that the cost, number as well as the severity of adverse effects will increase. It is therefore reasonable to adopt criteria to ensure maximum efficiency and patient safety. IL-28B polymorphism is one of the factors associated with the treatment outcome and has been closely linked to interferon response.
Purpose To describe the implementation of the determination of the IL-28B polymorphism, rs12979860, and the results obtained, in order to personalise the treatment in HCV mono-infected patients in a tertiary hospital.
Materials and Methods We designed a standard form for HCV patients starting treatment with protease inhibitors. It includes several items that require clinical evaluation: viral load, HCV genotype, FibroScan and/or liver biopsy, response to previous treatment and polymorphism of the IL-28B genotype. Homozygous CC is the favourable genotype, predicting a good response. CT and TT genotypes are considered unfavourable.
The test was conducted in the pharmacogenetics area of the pharmacy department. To calculate the response time, we considered how long it takes to get the different responses.
The results were added to the hospital’s electronic medical records programme for easy reference online.
Results A total of 26 genotypes was determined, of which 11 (42%) were requested by the department of infectious diseases (56% co-infected), 10 (38%) by the hepatology department and 5 (18%) by an external department. Results 15 (58%) were CT, 8 (31%) CC and 3 (11%) TT. 100% of patients had a score of FibroScan > 9.5 kPascal. The response for the tests was on average 3 to 7 days, with the limiting factor the sequencer availability.
Conclusions IL28B determination has been added to the hospital’s services portfolio as a clinical assessment tool for the treatment of hepatitis C, with a response time of 3–7 days.
No conflict of interest.
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