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Abstract Details
Role of IL28B Gene Polymorphism and Cell-Mediated Immunity in Spontaneous Resolution of Acute Hepatitis C
Spada E, Amoroso P, Taliani G, Zuccaro O, Chiriacò P, Maio P, Maio G, Esposito ML, Mariano C, Rinaldi R, Bellissima P, Tosti ME, Del Porto P, Francavilla R, Mellace V, Garbuglia AR, Folgori A, Mele A; for the Acute Hepatitis Italian Study Group. Clin Infect Dis. 2013 Jul 9. [Epub ahead of print]
Collaborators (21)
Source
National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome.
Abstract
Background. A single-nucleotide polymorphism (SNP; rs12979860) near the IL28B gene has been associated with spontaneous and treatment-induced hepatitis C virus clearance. We investigated predictors of spontaneous disease resolution in a cohort of patients with acute hepatitis C (AHC), analyzing epidemiological, clinical and virological parameters together with IL28B.rs12979860 genotypes and cell-mediated immunity (CMI). Methods. Fifty-six symptomatic AHC patients were enrolled and followed prospectively. CMI was measured in 31 patients at multiple time points by interferon-γ enzyme-linked immunospot assay and was correlated to the IL28B.rs12979860 SNP. Results. Eighteen patients had a self-limiting AHC that was associated with female sex (P = .028), older age (P = .018), alanine aminotransferase level >1000 U/L (P = .027), total bilirubin level >7 mg/dL (P = .036), and IL28B.rs12979860 genotype CC (P = .030). In multivariate analysis, only CC genotype was independently associated with self-limiting AHC (odds ratio, 5.3; 95% confidence interval, 1.1-26.5). Patients with the CC genotype with self-limiting AHC had a stronger (P = .02) and broader (P = .013) CMI than patients with the CT genotype with chronically evolving AHC. In patients with chronically evolving disease, CC genotype was associated with a broader CMI compared to CT genotype (P = .028). A negative CMI was more frequently associated with CT genotype among persistently infected patients (P = .043) and with persistent infection among CT patients (P = .033). Conclusions. Self-limiting AHC was independently associated with CC genotype. The correlation between IL28B.rs12979860 genotypes and CMI is suggestive of a possible important role of CMI in favoring hepatitis C virus clearance in CC patients.