Published online Nov 18, 2015. doi: 10.4254/wjh.v7.i26.2681
Peer-review started: June 30, 2015
First decision: August 16, 2015
Revised: October 15, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: November 18, 2015
Hepatitis C virus (HCV) infection is a major health concern worldwide. Interferon-α (IFN-α) therapy has been the main antiviral treatment for more than 20 years. Because of its established antitumor effects, IFN-based treatments for chronic HCV infection still have a clinical impact, particularly for patients with high risk conditions of developing hepatocellular carcinoma, such as older age and advanced liver fibrosis. As a result of exhaustive research, several viral factors, including NS5A amino acid mutations such as the IFN sensitivity-determining region and the IFN/ribavirin resistance-determining region, and mutations of amino acids in the core protein region (core 70 and 91) were shown to be associated with the response to IFN-α treatment. In addition, among the host factors related to the response to IFN-α treatment, polymorphisms of the interleukin-28B gene were identified to be the most important factor. In this article, we review the factors associated with the efficacy of IFN-α treatment for chronic HCV infection. In addition, our recent findings regarding the possible involvement of anti-IFN-α neutralizing antibodies in a non-response to pegylated-IFN-α treatment are also described.
Core tip: Interferon-α (IFN-α) therapy has been playing a central role in anti-hepatitis C virus (HCV) strategies, and several viral and host factors related to the treatment efficacy have been identified. After the development of pegylated-IFN-α (Peg-IFN-α), the clinical impact of anti-IFN-α neutralizing antibodies in the treatment for HCV infection has not been sufficiently addressed. We recently found that anti-IFN-α neutralizing antibodies were associated with a non-response to Peg-IFN-α treatment. Our findings provide important information for the treatment of chronic hepatitis C in the clinical setting.