Inter Leuken 28B (IL28B) Polymorphism

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.

Frequently asked questions

Can Hepatitis C be detected early?

Since the condition is usually asymptomatic in the initial stages, it can be difficult to tell when an individual has hepatitis C. However, some common symptoms may appear 2-12 weeks after infection. These include: Fever and fatigue Pain in the abdominal area Loss of appetite Nausea Unusual colour in urine and stool Sudden joint pain

Who should be tested for HCV?

Due to the possibility of HCV resulting in degenerative liver disease, it is essential to be proactive in testing. Individuals who should consider an HCV test are: Adults over the age of 18 years  Pregnant women  Anyone with a history of injected drug usage  HIV-positive patients People who received recent blood donations

Is hepatitis curable?

Despite its severity, hepatitis is curable. Individual treatment options can reduce the virus to undetectable levels. The infection is deemed cured if the virus is not detected 12 weeks after treatment completion.

When should an IL28B Polymorphism test be administered?

The IL28B Polymorphism test is widely used in the case of HCV-positive patients. However, due to it being evaluative, all individuals are advised to get the test administered at one point. That would help ease potential treatment processes in the future.

Why is IL28B Polymorphism test necessary if it doesn't help diagnose hepatitis C?

Each individual reacts differently to the HCV treatment, with SVR being dependent on specific genotypes. The test is necessary because it can recognise individual genotypes. Without that, treatment options and dosage levels cannot be effective.

Are there any prior requirements to take the IL28B Polymorphism test?

There are no prior requirements to take the IL28B Polymorphism test. The medical professionals usually conduct this test through a blood sample. In some cases, buccal samples are also used. However, to ensure minimal test interference, it is advisable to avoid alcoholic beverages and nicotine-based products 24 hours before the test.