Published online Sep 18, 2016. doi: 10.4254/wjh.v8.i26.1116
Peer-review started: April 5, 2016
First decision: May 17, 2016
Revised: June 29, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: September 18, 2016
Processing time: 162 Days and 8.4 Hours
In Pakistan which ranked second in terms of hepatitis C virus (HCV) infection, it is highly needed to have an established diagnostic test for antiviral therapy response prediction. Interleukin 28B (IL-28B) genetic testing is widely used throughout the world for interferon based therapy prediction for HCV patients and is quite helpful not only for health care workers but also for the patients. There is a strong relationship between single nucleotide polymorphisms at or near the IL-28B gene and the sustained virological response with pegylated interferon plus ribavirin treatment for chronic hepatitis C. Pakistan is a resource limited country, with very low per capita income and there is no proper social security (health insurance) system. The allocated health budget by the government is very low and is used on other health emergencies like polio virus and dengue virus infection. Therefore it is proposed that there should be a well established diagnostic test on the basis of IL-28B which can predict the antiviral therapy response to strengthen health care set-up of Pakistan. This test once established will help in better management of HCV infected patients.
Core tip: Pakistan has a very heavy burden of hepatitis C virus (HCV) infection with around 11 million positive cases; however, in spite of well established prognostic value, the data regarding the role of interleukin 28B (IL-28B) single nucleotide polymorphisms (SNPs) in HCV antiviral therapy response are very limited. There are only six reports on the topic and it can be concluded from this limited information that IL-28B could be a good prognosis marker for HCV patient management in Pakistan. The major prevalent HCV genotype in Pakistan is 3a and IL-28B SNP rs12979860 showed a good prediction for interferon based antiviral therapy response against this viral genotype. It can be predicted that inclusion of IL-28B genetic testing in routine diagnostic set-up of Pakistan will help in better management of the disease. A well directed antiviral therapy based on personalized IL-28B genotyping along with virus genotyping will help in lessening of therapy cost and better management of the disease.