Interleukin-28B polymorphism in hepatitis C and liver transplantation

Andres Duarte-Rojo, Matthew G. Deneke, Michael R. Charlton

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The discovery of interleukin-28B (IL-28B) single-nucleotide polymorphisms has opened an important new area of research in liver transplantation (LT) for hepatitis C virus (HCV). Both recipient- and donor-derived IL-28B genotypes affect the post-LT treatment response, with sustained virological response (SVR) rates oscillating from >50% in homozygotes for the favorable allele (up to 90% when this is present in both the recipient and the donor) to <15% in homozygotes for the unfavorable allele and from 30% to 50% in heterozygotes. Other key posttransplant outcomes affected by the IL-28B genotype are the time to histological recurrence, HCV RNA and alanine aminotransferase levels, histological variables (including the rate of fibrosis progression), and hepatocellular carcinoma. Interactions between donor and recipient IL-28B genotypes are complex and may affect outcomes not directly related to HCV infections, such as acute cellular rejection (ACR) and metabolic diseases. A preferential allocation system in which livers from donors homozygous for the favorable allele are given to HCV patients might be postulated to improve SVR rates and post-LT outcomes in recipients with HCV infections (a 25% increase in SVR and an 8% decrease in mortality at 5 years). Although negative effects from this are difficult to predict, they could include an accelerated progression of fibrosis in patients with failed HCV eradication and an increase in ACR in non-HCV patients. Our knowledge of the precise role of IL-28B genotypes in the course of post-LT HCV is evolving, but existing knowledge suggests the possibility of exploring strategies that use IL-28B genotyping to reduce the impact of post-LT adverse outcomes.

Original languageEnglish (US)
Pages (from-to)49-58
Number of pages10
JournalLiver Transplantation
Volume19
Issue number1
DOIs
StatePublished - Jan 2013

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Interleukins
Hepatitis C
Hepacivirus
Liver Transplantation
Genotype
Tissue Donors
Alleles
Homozygote
Virus Diseases
Fibrosis
Metabolic Diseases
Heterozygote
Alanine Transaminase
Single Nucleotide Polymorphism
Hepatocellular Carcinoma
RNA
Viruses
Recurrence
Mortality
Liver

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Cite this

Interleukin-28B polymorphism in hepatitis C and liver transplantation. / Duarte-Rojo, Andres; Deneke, Matthew G.; Charlton, Michael R.

In: Liver Transplantation, Vol. 19, No. 1, 01.2013, p. 49-58.

Research output: Contribution to journalArticle

Duarte-Rojo, Andres ; Deneke, Matthew G. ; Charlton, Michael R. / Interleukin-28B polymorphism in hepatitis C and liver transplantation. In: Liver Transplantation. 2013 ; Vol. 19, No. 1. pp. 49-58.
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