003) was noted between the major allele group and minor allele group (Fig. 2b). Various side-effects were observed in our patients (Table 2). Symptoms BAY 57-1293 research buy including fever, lethargy, headache, anorexia, and hair loss were commonly noted. In three patients the

treatment was stopped due to the severe degree of adverse effects including one patient each with fever, mental depression, and anemia. Those three patients eventually achieved an SVR after a premature cessation of treatment. Linear growth impairment with a decrease of growth velocity below the 3rd percentile was observed in two patients, but catch-up growth in height was confirmed in these patients within 12 months after the treatment ended. The degree of hair loss was mild and none of the seven patients who presented with hair loss needed a hairpiece or wig. Leucopenia was also common (Table 2) and six patients had a dose reduction of peginterferon. Similarly, a dose reduction of ribavirin was necessary in four patients due to anemia. In the present study, an IL28B gene polymorphism was analyzed in children and adolescents with chronic hepatitis C infection. Our results show that the IL28B polymorphism is closely associated with the therapeutic

effects of PEG-IFN/RBV therapy; SVR was achieved in 90% of genotype-1 patients PD-0332991 manufacturer with IL28B major alleles whereas it was achieved in only 17% of genotype-1 patients with IL28B minor alleles. Although drug adherence could influence SVR, all patients with genotype

1 had sufficient adherence (≥80%) for both drugs. Our results suggest that a current standard PEG-IFN/RBV therapy in children and adolescents who were not available for protease inhibitor, may yield considerably better therapeutic effects in genotype-2 patients as well as in genotype-1 patients with IL28B major alleles. On the other hand, as the response rate may be substantially lower in genotype-1 patients with IL28B minor alleles, treatment strategies should be carefully implemented in the IL28B unfavorable group of patients. IL28B polymorphism has been reported to contribute to the therapeutic effect of PEG-IFN/RBV therapy in adult patients with genotype-l HCV. In the previous studies of Japanese patients with chronic hepatitis C, more than 70% of non-responders had a minor allele G at rs8099917 (TG/GG) around the IL28B gene.[3, 17] The IL28B genotype is a useful baseline MCE predictor of virological response which should be used in selecting the treatment regimen; whether to treat patients with PEG-IFN and RBV or to wait for promising new therapies including direct acting antiviral drugs.[18, 19] The cost of PEG-IFN/RBV therapy is very high and it may result in severe adverse effects including depression, anemia, and hair loss. Therefore, a reliable prediction of the effectiveness of this regimen, especially in patients who are less likely to respond, may save those patients from ineffective treatment with potentially severe adverse effects.