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Update on Genetic Links to HCV Clearance Todd Wills, MD ETAC Infectious Disease Specialist HEPATITIS C TREATMENT EXPANSION INITIATIVE MULTISITE CONFERENCE CALL FEBRUARY 20, 2013 Percentage of SVR by genotypes for IL-28B region DL Ge et al. Nature 461, 399-401(2009) Clinical Correlates of IL28B CC Genotype • Spontaneous Clearance of HCV infection • Improved response to interferon based treatment • Faster progression to cirrhosis in HIV infection • Treatment effect less significant with HCV direct acting antivirals • Potential role in treatment decisions in acute HCV infection Barreiro P et al. J Infect Dis. 2011;203:1629-1636 DL Ge et al. Nature 461, 399-401(2009) Genetic Loci Associated with Spontaneous Clearance of HCV Duggal, P. et al. Annals of Internal Medicine. 158(4):235-245, February 19, 2013. Conditional Analysis of Allele Effect – HLA and IL28B Duggal, P. et al. Annals of Internal Medicine. 158(4):235-245, February 19, 2013. Clinical Correlates of HLA loci (DQB1*03:01 ) • Increased rate of HCV spontaneous clearance • Does not effect response to treatment • May be associated with preserved HCV specific proliferative CD4 response Duggal, P. et al. Annals of Internal Medicine. 158(4):235-245, February 19, 2013.