Letters To The Editor
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 18, 2016; 8(26): 1116-1118
Published online Sep 18, 2016. doi: 10.4254/wjh.v8.i26.1116
Predictive potential of IL-28B genetic testing for interferon based hepatitis C virus therapy in Pakistan: Current scenario and future perspective
Muhammad Sohail Afzal
Muhammad Sohail Afzal, Department of Chemistry, School of Science, University of Management and Technology, Lahore 54000, Pakistan
Author contributions: Afzal MS designed the research, analyzed the data, wrote the letter, and revised the letter.
Conflict-of-interest statement: Afzal MS declares that there is no conflict of interest in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Muhammad Sohail Afzal, PhD, Department of Chemistry, School of Science, University of Management and Technology, C-II Johar Town, Lahore 54000, Pakistan. sohail.ncvi@gmail.com
Telephone: +92-321-5244808
Received: April 5, 2016
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
Abstract

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.

Keywords: Diagnostics, Hepatitis C virus, Interferon therapy, Polymorphisms, IL-28B, Genetic testing, Pakistan

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.