Predict response to peginterferon (PEG-IFNalpha) and ribavirin (RBV) therapy for chronic HCV-1 infection.
- Patient Preparation
- Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).
- Specimen Preparation
- Transport 3 mL whole blood. (Min: 1 mL)
- Storage/Transport Temperature
- Unacceptable Conditions
- Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
Characteristics: Hepatitis C is an infectious disease that can result in cirrhosis, liver failure, and hepatocellular carcinoma in chronically infected individuals. Hepatitis C virus (HCV) is categorized into six genotypes; HCV genotype 1 (HCV-1) accounts for 75 percent of U.S. cases. Therapy for chronic infection consists of a combination of peginterferon (PEG-IFN alpha) and ribavirin (RBV), which is effective in eliminating HCV-1 in 40 to 50 percent of individuals. Single nucleotide polymorphisms (SNPs) rs12979860 C/T and rs8099917 T/G located upstream of the IL28B gene (encoding for lambda or type III interferons), have been associated with both spontaneous clearance and response to PEG-IFN alpha/RBV therapy in individuals infected with HCV-1. For SNP rs12979860, the CC genotype is associated with a two-to threefold greater rate of sustained virological response (SVR) following PEG-IFN alpha/RBV therapy, while the TC and TT genotypes are less likely to respond to treatment. For SNP rs8099917, the TT genotype is associated with a higher rate of SVR after PEG-IFN alpha/RBV therapy, while the GT and GG genotypes are less likely to respond to treatment and achieve SVR.
Prevalence: 4.1 million Americans (1.6 percent of the U.S. population) have anti-HCV antibodies.
Allele Frequency: SNP rs12979860 favorable C allele: East Asian 0.90, Caucasian 0.75, Hispanic 0.70, and African American 0.50. SNP rs8099917 favorable T allele: Caucasian 0.75, Asian 0.88, and unknown in other ethnicities.
Variants Tested: SNP rs12979860 C/T and SNP rs8099917 T/G.
Clinical Sensitivity: Unknown.
Methodology: Polymerase chain reaction followed by single nucleotide extension (SNE) and capillary electrophoresis.
Analytical Sensitivity & Specificity: 99 percent.
Limitations: SNPs other than those targeted will not be detected. Mutations in other genes and non-genetic factors that may affect response to hepatitis C therapy are not detected. For HCV genotypes other than type 1, the usefulness of these SNPs for predicting response to therapy is unknown. Diagnostic errors can occur due to rare sequence variations.
Counseling and informed consent are recommended for genetic testing. Consent forms are available online.
|Component Test Code*||Component Chart Name||LOINC|
|2004681||IL28B-Assoc Variants, 2 SNPs Specimen||31208-2|
|2012617||IL28B-Assoc Variants, 2 SNPs Interp|
- Hepatitis C Virus Genotyping
- Interleukin 28B Polymorphism
- Lambda Interferon Genotyping
- Ribavirin Genotyping (Interleukin 28 B (IL28B)-Associated Variants, 2 SNPs)