Impact of Interleukin 28B (rs12979860) Genotype on Virological Responses Chronic Hepatitis C Treatment

April 22, 2017 updated by: Sheikh Zayed Medical College

Impact of Interleukin 28B (rs12979860) Genotype on Virological Responses in Chronic Hepatitis C Treatment

Objective:

Pegulated Interferon α2 plus ribavirin is a treatment of choice in patients with chronic hepatitis C infection. This study was conducted to find out the frequency of different IL-28B (rs12979860) genotypes in patients with chronic hepatitis C (HCV genotype type 2 & 3) infection treated with Pegulated Interferon α2 plus ribavirin and to evaluate the role of IL-28B genotypes in achieving Sustained Virological Response (SVR).

Methods:

In this non-randomized observational study, ninety eight (98) patients with diagnosis of chronic hepatitis C were included. In all patients, Peg-IFN plus Ribavirin were given in standard doses for 24 weeks. End treatment response, sustained virological response, and relapse rate were the primary endpoints of this study. Analysis of IL28B (rs12979860) polymorphism (CC, CT and TT) was performed by PCR-RFLP protocol.

Study Overview

Status

Completed

Detailed Description

INTRODUCTION:

Hepatitis C virus (HCV) is a major health problem that effects nearly 170 million people worldwide [1, 2]. According to a report, about 64-103 million people are suffering from chronic HCV infection [3] and this chronic infection results in liver scarring, hepatocellular carcinoma or end-stage liver disease in about forty thousand (40,000) patients every year [4, 5]. According to WHO, liver disease initiated by chronic hepatitis C infection is responsible for more than 35 thousand deaths and 3 to 4 million people are infected every year[3, 6]. Hepatitis C Virus has been classified into seven genotypes and several subtypes, which are associated with distinct forms of geographic dispersal [7, 8]. The success of HCV treatment is affected by many viral, treatment or host factors.

Pegulated Interferon α2 plus ribavirin is a treatment of choice in patients with chronic hepatitis C infection. Sustained virological response (SVR) rate with this treatment in HCV-2 & 3 has been reported to be 58-84% in previously untreated patients [9]. SVR can be affected by liver cirrhosis, hepatocellular carcinoma, ethnicity, age, gender and obesity. [10, 11] It has been clarified by some studies that interleukin-28B has an important role in the treatment success of HCV infection and IL-28B CC genotype is associated with 2 folds higher sustained virological response (SVR) as compared to CT and TT genotype [12-14]. The aim of present study was to find out the frequency of different IL28B (rs12979860) genotypes in patients with chronic hepatitis C (genotype type 2 or 3) infection treated with Pegulated Interferon α2 plus ribavirin and to evaluate the role of IL-28B genotypes in achieving Sustained Virological Response (SVR).

METHODS:

This non-randomized observational study was conducted in Sheikh Zayed Medical College/Hospital Rahim Yaar Khan. A total of ninety eight (98) patients with diagnosis of chronic hepatitis C genotype 2 or 3 were involved in this study. The duration of study was from January 2015 to January 2016. People living in Rahim Yaar Khan City belongs to different ethinic backgrounds because this city is located at the junction of three provinces of Pakistan (total provinces are four), so people residing here represent the whole Pakistani population living in different provinces. Institutional ethical approval was taken before starting this research work. A written informed consent was taken from every patient before including him/her in this study.

The diagnosis of chronic hepatitis C was made through liver enzyme levels, HCV-RNA positivity and anti-HCV antibody test. Patients with other chronic liver disorders, with positive hepatitis B virus (HBV), and human immunodeficiency virus (HIV) infection were excluded from this study.

Treatment Protocol and Detection of IL28B Polymorphism:

In all patients Pegulated Interferon α2 (pegIFN) plus Ribavirin were given in standard doses. PegINF was given in a dose of 180 μg/week and ribavirin 1200 mg/day to every patient for the period of 24 weeks for HCV genotype 2 & 3.

PCR analysis was done in every patient before starting the treatment, after 24 weeks of treatment (to see end treatment response) and 48 weeks (to evaluate SVR and relapse rate) of treatment. Analysis of IL28B (rs12979860) polymorphism (CC, CT and TT) was performed by PCR restriction fragment length polymorphism (RFLP) assay protocol. Pyrosequencing method was used to determine HCV genotypes.

Data analysis was done using SPSS V17 software. Mean and standard deviation were used for the presentation of quantitative variables. Frequency and percentages were used to present qualitative data. Chi-square test/Fisher Exact test was used to compare qualitative data. P-value <0.05 was taken as significant.

Study Type

Interventional

Enrollment (Actual)

98

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Punjab
      • Sadiqabad, Punjab, Pakistan, 64200
        • Muhammad Zafar Majeed Babar

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • patients with diagnosis of chronic hepatitis C genotype 2 or 3

Exclusion Criteria:

  • Patients with hepatitis genotype I and IV

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: chronic hepatitis C genotype 2 or 3
In all patients Pegylated Interferon α2 (pegIFN) plus Ribavirin were given in standard doses. Peg-INF was given in a dose of 180 μg/week and ribavirin 1200 mg/day to every patient for the period of 24 weeks for HCV genotype 2 & 3
Peg-INF was given in a dose of 180 μg/week
Other Names:
  • Unipg
ribavirin 1200 mg/day to every patient for the period of 24 weeks for HCV genotype 2 & 3
Other Names:
  • Ribavil

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment Success rate
Time Frame: after 24 weeks of treatment
Treatment Success rate (End Treatment Response) was noted to check the adequency of treatment
after 24 weeks of treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sustained Virological Response
Time Frame: After 48 weeks of treament
Sustained Virological Response was noted to check treatment success after extended period
After 48 weeks of treament
Relapse Rate
Time Frame: After 48 weeks of treament
Relapse Rate to check re-occurrence of Hepatitis infection
After 48 weeks of treament

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Muhammad ZM Babar, FCPS, Sheikh Zayed Medical College/Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2014

Primary Completion (Actual)

July 1, 2014

Study Completion (Actual)

December 31, 2014

Study Registration Dates

First Submitted

February 27, 2017

First Submitted That Met QC Criteria

March 19, 2017

First Posted (Actual)

March 24, 2017

Study Record Updates

Last Update Posted (Actual)

April 25, 2017

Last Update Submitted That Met QC Criteria

April 22, 2017

Last Verified

April 1, 2017

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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