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Utilizing genomic polymorphisms to personalize hepatitis C therapies

Rifai, Muhamad Aly; Sabouni, Mouhamed Amr

Current Opinion in Organ Transplantation: April 2012 - Volume 17 - Issue 2 - p 198–203
doi: 10.1097/MOT.0b013e328351093b
ETHICAL, LEGAL AND FINANCIAL CONSIDERATIONS: Edited by Kathy Coffman
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Purpose of review The need for liver transplant due to the progression of hepatitis C virus (HCV) infection necessitates the consideration of antiviral treatment. Host genomic variations affect response to HCV treatment and predict the rates of adverse effects. Recently, multiple genomic polymorphisms were found to be critical in predicting treatment response as well as the rate of neuropsychiatric adverse effects in patients infected with HCV who are receiving antiviral treatments.

Recent findings The use of antiviral treatments (pegylated IFN-alpha and ribavirin) to clear HCV infection is associated with poor response in HCV genotype 1 and with the development of depression. Polymorphisms in the promoter region of the IFN-alpha/beta receptor 1 (IFNAR1) can influence the risk of developing depression. Similar polymorphisms in the IL28B gene encoding for IFN-λ-3 are associated with a two- to three-fold improvement in response to treatment.

Summary In patients with HCV infection receiving antiviral treatments, genomic variations in two genes can help predict the increased risk of developing depression and the likelihood of achieving virus clearance. This can identify patients who are at an increased likelihood of virus clearance and who should be targeted to receive prophylactic approaches (antidepressants, psychotropics) to prevent the development of depression during HCV antiviral treatment.

Blue Mountain Health System, Lehighton, Pennsylvania, The Commonwealth Medical College, Scranton, Pennsylvania, USA

Correspondence to Muhamad Aly Rifai, MD, CPE, FACP, FAPM, FAPA, Chairman, Department of Psychiatry, Blue Mountain Health System, PO Box 1360, Easton PA 18044, USA. Tel: +1 484 464 0863; fax: +1 484 898 0334; e-mail: RifaiPsychiatry@aol.com

© 2012 Lippincott Williams & Wilkins, Inc.