Inter Leuken 28B (IL28B) Polymorphism in Ganguly Bagan, Kolkata

Hepatitis C is an infectious blood-borne viral disease caused by the Hepatitis C Virus (HCV). The condition results in the virus invading liver cells which can cause inflammation in the liver.

If left untreated, the consequences for the patient can be fatal. The infection is usually asymptomatic in the initial stages, which compounds its severity. Even if patients show signs of hepatitis C, it can take anywhere from 2-12 weeks post-infection for its detection.

The hepatitis C infection can be:

• Acute: Short-term and only lasts for up to 6 months.
• Chronic: Degenerative condition that happens when the body fails to clear the HCV after treatment.

In most cases, the infection may turn chronic. To detect it at the earliest opportunity, individuals can look for these common symptoms: 

• Fever
• Fatigue
• Abdominal pain
• Reduced appetite
• Nausea
• Discoloured urine and stool
• Joint pain
• Jaundice (Rarely)

If not detected early or upon treatment failure, chronic hepatitis C can result in:

• Degenerative liver diseases
• Liver scarring
• Hepatocellular carcinoma (Liver cancer)
• Organ failure and death

The current treatment for HCV combines ribavirin (RBV) and pegylated interferon (peg-IFN). These antiviral medications are meant to prevent health complications and minimise the risk of death due to HCV. However, in some cases, HCV may exhibit a condition called genetic polymorphism. Thus, the effectiveness of HCV treatment can only be gauged by the IL28B Polymorphism test.

The IL28B Polymorphism test is a predictive hepatitis test that evaluates patients' sustained virologic response (SVR). The purpose of the test is not to cure the infection. Instead, it provides doctors with the necessary information to formulate a treatment plan.

IL28B is a gene located in the human body. The efficiency of HCV treatment is dependent on the patient’s specific IL28B genotype. Following are the genotype variants:

• IL28B CC: Patients with this genotype respond very well to HCV treatment.
• IL28B CT: Patients with this genotype are resistant to HCV treatment.
• IL28B TT: Patients with this genotype have increased difficulty responding to HCV treatment.

When administered, the IL28B Polymorphism test reveals the patient's genotype. Depending on the variant, doctors can determine how effective RBV and peg-IFN will be on a particular patient. Dosage levels for the two antiviral medications can also be based on this information. Patients can also opt for this predictive hepatitis test as a precautionary measure in case they suspect probable infection.

The most common modes of transmission of infection include:

• Non-sterile needles
• Unscreened blood transfusions
• Illicit drug usage
• Maternal contact with an infant (pregnancy, labour and nursing)

If an HCV-positive woman has recently given birth, the infant should be tested for the same in the first three months. If more time passes, it can lead to the loss of maternal antibodies, increasing the risk of infection.

Apollo 24|7 has a comprehensive IL28B Polymorphism test that evaluates all related aspects of HCV treatment, which includes:

• Patient’s SVR (Likelihood of the HCV returning post-treatment)
• RBV and peg-IFN dosage level and efficiency
• Additional required patient care and HCV treatment options

Medically reviewed by Dr. Shravan Bohra, Gastroenterologist, Apollo Hospitals Gandhinagar, Ahmedabad.