Clinical Advances in Liver, Pancreas, and Biliary TractA Polymorphism Near IL28B Is Associated With Spontaneous Clearance of Acute Hepatitis C Virus and Jaundice
Section snippets
Study Population
Between 1978 and 1979, Rhesus factor–negative women were exposed to contaminated batches and anti-D prophylaxis in the former German Democratic Republic. At least 2867 women had documented exposure. A 25-year follow-up study evaluated liver-related outcome in a total of 1980 of the original 2867 women; of these 1980 women, only 48% developed chronic hepatitis, 52% had a self-limited infection, 7% had no acute hepatitis and no proof of infection, and 45% were identified as having self-limited
Patient Characteristics
The mean age at infection was 24.6 ± 4 years, with no significant difference among patients with C/C, C/T, or T/T genotypes, which was similar to the earlier reports on this cohort.15, 16 All were white female patients who were postpartum or who had undergone a therapeutic or spontaneous abortion and were from a limited geographic area with similar socioeconomic living conditions. No patients were or are currently known to be coinfected with human immunodeficiency virus or hepatitis B virus. No
Discussion
We describe a strikingly significant difference in spontaneous hepatitis C viral clearance rates in the women from the East German anti-D cohort associated with a recently described SNP in close association with the IL28B gene. This confirms and accentuates the findings of Thomas et al and Rauch et al because the association of IL28B with spontaneous clearance seemed more pronounced, although not statistically different, in our study compared with those described by Thomas et al and Rauch et al
Acknowledgments
The authors thank Karen Pieper and Dongliang Ge for their helpful statistical advice and discussion.
Members of the German anti-D Study Group include Rüdiger Behrens (Halle), Thomas Berg (Berlin, Leipzig), Silvio Frimmel (Rostock), Wolfgang Klemm (Cottbus), Micha Loebermann (Rostock), Edeltraud Meyer-Siegert (Berlin), Ute Oesen (Chemnitz), Norbert Steudel (Halle), Tatjana Walther (Chemnitz), Viola Weich (Berlin), Sven Wollschläger (Dresden), Alexander Zipprich (Halle), Michael Roggendorf
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Conflicts of interest The authors disclose the following: Drs Thompson, Shianna, McHutchison, and Goldstein are coinventors of a patent in relation to IL28B polymorphism and treatment response. The remaining authors disclose no conflicts.
Funding Supported by the German “Network of Competence for Hepatitis” (now Deutsche Leberstiftung; H.L.T., H.T., J.N., and U.S.), Wilhelm Sander Stiftung Project 2009.045.1 (J.T. and J.N.), the Duke Clinical Research Institute (H.L.T., A.J.T., K.P., and J.G.M.), and the Duke Institute for Genomic Science and Policy (K.V.S. and D.B.G.). A.J.T. also received funding support from the Richard B. Boebel Family Fund, the National Health and Medical Research Council of Australia, the Gastroenterological Society of Australia, and the Royal Australasian College of Physicians.