The Role of IL28B Genotype Testing in the Era of Direct Acting Antiviral Agents.

The new era of Hepatitis C management is marked by newly available tests for IL28B polymorphisms, US Food and Drug Administration (FDA) approval of the first direct acting antivirals (DAA; boceprevir and telaprevir), monitoring of drug-related mutations and emerging data on new classes of DAAs and second wave and second generation protease inhibitors. With the previous standard of care (pegylated interferon-alpha and ribavirin), baseline predictors were regularly used to determine treatment candidacy, and recently, IL28B genetic polymorphisms have been identified as the strongest baseline predictors of treatment response. Yet the role of IL28B genotype testing and other baseline predictors is less clear in the setting of DAAs. We will review the current literature assessing the role of IL28B genetic variation in the setting of DAAs and discuss the potential indication for IL28B genotype testing in treatment decision-making in this new therapeutic era.