Pegylated interferon (Peg-IFN) may achieve a sustained off-treatment response in 20-30% of the patients with chronic hepatitis B (CHB). However, given the high cost of treatment, the frequent side effects, and the lack of effectiveness in a large proportion of patients, there have been attempts to identify the subjects who are most likely to benefit with such therapy. Response rates may be significantly increased by careful selection of patients based upon baseline serum alanine aminotransferase, HBV DNA levels, and viral genotype. Recently, genome-wide association studies identified polymorphisms of the interleukin 28B (IL28B) gene as a potent predictor of sustained viral response in chronic hepatitis C patients treated with Peg-IFN plus Ribavirin, encouraging similar studies in HBV. Overall, these studies failed to provide convincing evidences that IL28B genotype significantly impacts on response to Peg-IFN in chronic hepatitis B (CHB) patients, though these studies are very heterogeneous in terms of patient populations, methodology, baseline features, treatment regimens, duration of follow-up, and ethnicity, making new studies in larger cohorts very much needed.
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