The genetics of virologic response
The likelihood of response for an individual patient treated with standard pegylated interferon alpha and ribavirin for hepatitis C is impacted by a combination of viral factors and patient factors. Infection with viral genotypes 2 or 3 is favorable for response to treatment compared to infection with other viral genotypes [1]. Patient factors known to improve treatment response include female sex, non-African-American ethnicity, and age. Other clinical predictors of treatment response include baseline viral load, degree of fi brosis, insulin resistance, and steatosis on liver biopsy [1– 4]. Recent discoveries of genetic variation within the HCV virus and within the human population have provided new insights into differences in treatment response among various populations. The fi eld of medicine is changing and it appears that we will soon enter an era where determination of the genetic makeup of pathogens and patients will be standard practice for clinical decision making. The developments that have occurred within the fi eld of HCV treatment are a step in this direction.
