ABSTRACT
Background and study aims: In chronic hepatitis C virus [HCV], viral and host factors are known to be predictors for anti-viral therapy. IL-28B genotype strongly influences treatment outcome, while Epstein-Barr virus [EBV] co-infection could accelerate the course of chronic HCV infection. This study was conducted to assess whether EBV co-infection adds to the predictive value of IL-28B
Patients and methods: A total of 105 patients with chronic HCV were classified according to their response to treatment into two groups: 38 sustained virological responders [SVRs] and 67 nonresponders [NRs]. Collected sera at baseline and follow-up [FUP] were used for assessing EBV antibodies by enzyme-linked immunosorbent assay [ELISA] and the expression of EBV genes [BNLF-1, BZLF-1, and EBER-2] by polymerase chain reaction [PCR]. Collected peripheral blood was used for detecting IL-28B rs.12979860 single-nucleotide polymorphism
Results: Regarding IL-28B genotype frequencies, a significant difference [p = 0.003] was observed between SVRs [C/C = 51.4%, C/T = 48.6%, T/T = 0%] and NRs [C/C = 25%, C/T = 55%, T/T = 20%]. On assessing EBV infection at baseline and FUP, it was found that 61% and 55% were positive, respectively, with no significant difference between SVRs and NRs. As for anti-viral capsid antigen [VCA] antibodies, the NRs had significantly higher baseline anti-VCA immunoglobulin M [IgM] levels than SVRs [p = 0.01]. While FUP anti-Epstein-Barr nuclear antigen-1 [EBNA-1] IgG reported a significant decline within SVR patients [p = 0.02], neither baseline nor FUP anti-VCA IgG levels showed a statistically significant viral response. Finally, on comparing EBV markers with CC versus CT and TT genotypes, it was found that FUP anti-VCA IgG levels were significantly increased in CC genotype [p = 0.003]
Conclusion: Interleukin-28B polymorphism could be a possible predictor of response to pegylated interferon/ribavirin therapy [PEG-IFN/RBV]. Furthermore, co-infection with EBV did not affect the response to IFN-based therapy in HCV-infected patients