Chemical: Drug
ribavirin

Available Guidelines

  1. CPIC Guideline for peginterferon alfa-2a,peginterferon alfa-2b,ribavirin and IFNL3
  2. DPWG Guideline for ribavirin and HLA-B

last updated 09/15/2016

1. CPIC Guideline for peginterferon alfa-2a,peginterferon alfa-2b,ribavirin and IFNL3

Summary

IFNL3 (IL28B) variation (rs12979860) is the strongest baseline predictor of response to PEG-interferon-alpha-containing regimens in HCV genotype 1 patients. Patients with the favorable response genotype (rs12979860 CC) have increased likelihood of response (higher SVR rate) to PEG-interferon-alpha-containing regimens as compared to patients with unfavorable response genotype (rs12979860 CT or TT). Consider implications before initiating PEG-IFN alpha and RBV containing regimens.

Annotation

February 2014

Accepted article preview online October 2013; Advance online publication November 2013.

  • Guidelines regarding the use of pharmacogenomic tests in PEG-interferon-alpha (PEG-IFN alpha) and ribavirin (RBV) therapy have been published in Clinical Pharmacology and Therapeutics by the Clinical Pharmacogenetics Implementation Consortium (CPIC).

  • These guidelines are applicable to

    • adults
  • Excerpt from the 2013 PEG-interferon-alpha therapy dosing guidelines:

    • "The role of IFNL3 genotyping depends on treatment selection. IFNL3 genotype is only one factor that could influence response rates to PEG-IFN alpha and RBV therapy in HCV genotype 1 infection and should be interpreted in the context of other clinical and genetic factors. "
    • "For patients treated with PEG-IFN alpha and RBV alone, IFNL3 genotype is the strongest pretreatment predictor of HCV treatment response. In the intention to treat analysis of the original discovery cohort with rs12979860, Caucasian CC genotype patients were more likely than CT or TT patients to be undetectable by week 4 (28% versus 5% and 5%, P<0.0001) and to achieve SVR (69% versus 33% and 27%, P<0.0001). Similar patterns were observed in Hispanic and African American patients in this cohort. HCV treatment is associated with significant side effects, and the likelihood of response treatment influences shared decision making between clinicians and patients about initiating treatment."
    • "For treatment naïve patients with genotype 1 infection who are treated with protease inhibitor combinations, all IFNL3 genotypes have improved response rates compared to PEG-IFN alpha and RBV only. However, patients with the favorable IFNL3 genotype still have higher response rates with the protease inhibitor combination in treatment naïve patients, and these response rates may guide patients and clinicians in their treatment decisions. In the boceprevir phase 3 naïve study of combination with PEG-IFN alpha and RBV, SVR rates for rs12979860 CC patients receiving boceprevir ranged from 80-82% compared to 65-71% for CT patients and 59-65% for TT patients. Moreover, multivariate regression analysis revealed that rs12979860 CC was a predictor of SVR compared to CT (odds ratio (OR) 2.6, 95% CI 1.3-5.1) and TT genotypes (OR 2.1, 95% CI 1.2-3.7)."
  • Download and read:

Table 1: Recommended therapeutic use of PEG-interferon-alpha containing regimens based on IFNL3 genotype

Adapted from Table 1 and 2 of the 2013 guideline manuscript

Genotype at rs12979860PhenotypeImplications for PEG-IFN alpha and RBV aImplications for protease inhibitor combinations with PEG-IFN alpha and RBV therapyClassification of recommendations b
CCFavorable response genotypeApproximately 70% chance for SVR c after 48 weeks of treatment. Consider implications before initiating PEG-IFN alpha and RBV containing regimens.Approximately 90% chance for SVR after 24-48 weeks of treatment. Approximately 80-90% of patients are eligible for shortened therapy (24-28 weeks vs. 48 weeks)d. Weighs in favor of using PEG-IFN alpha and RBV containing regimens.Strong
CT or TTUnfavorable response genotypeApproximately 30% chance for SVR c after 48 weeks of treatment. Consider implications before initiating PEG-IFN alpha and RBV containing regimens.Approximately 60% chance for SVR after 24-48 weeks of treatment. Approximately 50% of patients are eligible for shortened therapy (24-28 weeks)d. Consider implications before initiating PEG-IFN and RBV containing regimens.Strong

a In cases where a protease inhibitor is not available.

b Rating scheme described in Supplement.

c SVR; sustained virologic response (defined by undetectable serum viral RNA 12-24 weeks after the end of treatment).

d Patients receiving boceprevir are eligible for 24-28 weeks instead of the standard 48 weeks if HCV RNA is undetectable by week eight. Patients receiving telaprevir are eligible for 24 weeks of therapy instead of the standard 48 weeks if HCV RNA is undetectable by week four.

PEG-IFN alpha: pegylated-interferon alpha 2a or 2b; RBV: ribavirin


last updated 08/25/2016

2. DPWG Guideline for ribavirin and HLA-B

Summary

Although there is some evidence for lower treatment response in HLA-B*44 negative patients, there are no dosing recommendations for ribavirin at this time.

Annotation

The Royal Dutch Pharmacists Association - Pharmacogenetics Working Group has evaluated therapeutic dose recommendations for ribavirin based on HLA-B*44 [Article:21412232]. They found some evidence for lower treatment response in HLA-B*44 negative patients. However, they conclude that there are no dosing recommendations at this time, "given that ~90% of the population is HLA-B*44-negative and that no alternative treatment is available."

GenotypeTherapeutic Dose RecommendationLevel of EvidenceClinical Relevance
HLA-B*44NonePublished controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints.Clinical effect (S): long-standing discomfort (48-168 hr) without permanent injury e.g. failure of therapy with tricyclic antidepressants, atypical antipsychotic drugs; extrapyramidal side effects; parkinsonism; ADE resulting from increased bioavailability of tricyclic antidepressants, metoprolol, propafenone (central effects e.g. dizziness); INR 4.5-6.0; neutropenia 1.0-1.5x109/l; leucopenia 2.0-3.0x109/l; thrombocytopenia 50-75x109/l
  • *See Methods or [Article:18253145] for definition of "good quality."
  • S: statistically significant difference.


1. FDA Label for ribavirin

Full label available at DailyMed

Genes and/or phenotypes found in this label

  • Hepatitis
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Hepatitis C
    • Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Hepatitis C, Chronic
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT

Clinical Variants that meet the highest level of criteria, manually curated by PharmGKB, are shown below.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for ribavirin

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available No VIP available VA HLA-A *01:01:01:01 N/A N/A N/A
No VIP available CA VA HLA-B *38:01:01 N/A N/A N/A
No VIP available CA VA HLA-B *44:02:01:01 N/A N/A N/A
No VIP available CA VA SLC6A4 HTTLPR long form (L allele) N/A N/A N/A
No VIP available CA VA SLC6A4 HTTLPR short form (S allele) N/A N/A N/A
No VIP available No VIP available VA UGT1A1 *1 N/A N/A N/A
No VIP available No VIP available VA UGT1A1 *28 N/A N/A N/A
No VIP available No Clinical Annotations available VA
rs10048158 NC_000017.10:g.64236318T>C, NC_000017.11:g.66240200T>C, rs17691108, rs59335053
T > C
SNP
No VIP available CA VA
rs10853728 NC_000019.10:g.39254506C>G, NC_000019.9:g.39745146C>G, rs386431231, rs59125921
C > G
C > T
SNP
No VIP available CA VA
rs10877012 NC_000012.11:g.58162085G>T, NC_000012.12:g.57768302G>T, NG_007076.1:g.3892C>A, NM_000785.3:c.-1261C>A, NM_005371.5:c.*694C>A, NM_023033.3:c.*872C>A, XM_005268873.1:c.*694C>A, rs57118883
G > T
SNP
No VIP available CA VA
rs1127354 NC_000020.10:g.3193842C>A, NC_000020.11:g.3213196C>A, NG_012093.1:g.8787C>A, NM_001267623.1:c.67-789C>A, NM_033453.3:c.94C>A, NM_181493.2:c.43C>A, NP_258412.1:p.Pro32Thr, NP_852470.1:p.Pro15Thr, NR_052000.1:n.194C>A, NR_052001.1:n.49-62C>A, NR_052002.1:n.286C>A, XM_006723564.2:c.94C>A, XM_006723565.2:c.67-789C>A, XM_011529234.1:c.94C>A, XM_011529235.1:c.94C>A, XP_006723627.1:p.Pro32Thr, XP_011527536.1:p.Pro32Thr, XP_011527537.1:p.Pro32Thr, rs111069069, rs11565932, rs117814751, rs16988347, rs3177087, rs3183216, rs41320251, rs52834049
C > A
SNP
P32T
No VIP available CA VA
rs11854484 NC_000015.10:g.45253280C>T, NC_000015.9:g.45545478C>T, NM_004212.3:c.65C>T, NP_004203.2:p.Pro22Leu, NR_120335.1:n.180+586G>A, XM_011522198.1:c.65C>T, XM_011522199.1:c.65C>T, XM_011522200.1:c.65C>T, XM_011522201.1:c.65C>T, XP_011520500.1:p.Pro22Leu, XP_011520501.1:p.Pro22Leu, XP_011520502.1:p.Pro22Leu, XP_011520503.1:p.Pro22Leu, XR_243147.1:n.270+501G>A, rs17215661, rs17525501, rs52805892, rs61637002
C > T
SNP
P22L
No VIP available CA VA
rs11881222 NC_000019.10:g.39244283A>G, NC_000019.9:g.39734923A>G, NG_042193.1:g.5689T>C, NM_172139.2:c.259-126T>C, XM_005258765.1:c.271-126T>C, XM_005258765.3:c.271-126T>C, XM_011526757.1:c.271-126T>C
A > G
SNP
No VIP available CA VA
rs12819210 NC_000012.11:g.121458400C>T, NC_000012.12:g.121020597C>T, NM_001261825.1:c.1119G>A, NM_003733.3:c.1509G>A, NM_198213.2:c.*499G>A, NP_001248754.1:p.Ser373=, NP_003724.1:p.Ser503=, rs58256009
C > T
SNP
S373S
No VIP available No Clinical Annotations available VA
rs12944940 NC_000017.10:g.64231716T>C, NC_000017.11:g.66235598T>C
T > C
SNP
No VIP available CA VA
rs12979860 NC_000019.10:g.39248147C>T, NC_000019.9:g.39738787C>T, NG_042193.1:g.1825G>A, NM_001276254.2:c.151-152G>A, NR_074079.1:n.429-152G>A, XM_011526757.1:c.-1595G>A
C > T
SNP
No VIP available CA VA
rs12980275 NC_000019.10:g.39241143A>G, NC_000019.9:g.39731783A>G, rs52807979, rs57533120
A > G
SNP
No VIP available CA VA
rs14158 NC_000019.10:g.11131368G>A, NC_000019.9:g.11242044G>A, NG_009060.1:g.46988G>A, NM_000527.4:c.*52G>A, NM_001195798.1:c.*52G>A, NM_001195799.1:c.*52G>A, NM_001195800.1:c.*52G>A, NM_001195803.1:c.*52G>A, XM_005259909.1:c.*52G>A, XM_011528010.1:c.*52G>A, XM_011528011.1:c.*52G>A, rs1061748, rs13306506, rs17242656, rs17698773, rs3170295, rs3826809, rs56446007, rs59130683
G > A
SNP
No VIP available No Clinical Annotations available VA
rs1503391 NC_000011.10:g.105041731A>C, NC_000011.9:g.104912458A>C, NM_001017534.1:c.275-12T>G, NM_052889.2:c.*44-12T>G, XM_011542583.1:c.479-12T>G, rs1792772, rs58077813
A > C
SNP
No VIP available CA VA
rs1544410 NC_000012.11:g.48239835C>T, NC_000012.12:g.47846052C>T, NG_008731.1:g.63980G>A, NM_000376.2:c.1024+283G>A, NM_001017535.1:c.1024+283G>A, NM_001017536.1:c.1174+283G>A, XM_006719587.2:c.1024+283G>A, XM_011538720.1:c.1024+283G>A, XR_944903.1:n.-763C>T, rs386536760, rs56495123, rs56911380
C > T
SNP
No VIP available No Clinical Annotations available VA
rs17461620 NC_000009.11:g.88963008C>T, NC_000009.12:g.86348093C>T, NM_001185059.1:c.521-1613G>A, NM_001185074.1:c.521-1613G>A, NM_024617.3:c.521-1613G>A, XM_005252205.1:c.521-1613G>A, XM_005252206.1:c.521-1613G>A, XM_005252207.1:c.521-1613G>A, XM_005252207.2:c.521-1613G>A, XM_005252208.1:c.521-1613G>A, XM_005252208.2:c.521-1613G>A, XM_005252209.1:c.521-1613G>A, XM_005252209.2:c.521-1613G>A, XM_006717283.1:c.521-1613G>A, XM_011519011.1:c.521-1613G>A, XM_011519012.1:c.521-1613G>A, XM_011519013.1:c.521-1613G>A, XM_011519014.1:c.521-1613G>A, XM_011519015.1:c.521-1613G>A, XM_011519016.1:c.521-1613G>A, XM_011519017.1:c.521-1613G>A, rs52825621, rs59590228
C > T
SNP
No VIP available No Clinical Annotations available VA
rs1792774 NC_000011.10:g.105041826C>T, NC_000011.9:g.104912553C>T, NM_001017534.1:c.275-107G>A, NM_052889.2:c.*44-107G>A, XM_011542583.1:c.479-107G>A, rs17375541, rs57988920
C > T
SNP
No VIP available CA VA
rs1800477 NC_000018.10:g.63318540C>T, NC_000018.9:g.60985773C>T, NG_009361.1:g.5841G>A, NM_000633.2:c.127G>A, NM_000657.2:c.127G>A, NP_000624.2:p.Ala43Thr, NP_000648.2:p.Ala43Thr, XM_005266735.1:c.127G>A, XM_011526135.1:c.127G>A, XP_005266792.1:p.Ala43Thr, XP_011524437.1:p.Ala43Thr, XR_245468.1:n.1239G>A, XR_935246.1:n.1239G>A, XR_935247.1:n.1239G>A, XR_935248.1:n.1018G>A, rs4987709
C > T
SNP
A43T
No VIP available CA VA
rs1800795 NC_000007.13:g.22766645C>G, NC_000007.14:g.22727026C>G, NG_011640.1:g.4880C>G, NM_000600.4:c.-237C>G, NM_001318095.1:c.-274C>G, NR_131935.1:n.54-321G>C, XM_005249745.1:c.-237C>G, XM_005249745.3:c.-237C>G, XM_005249746.1:c.-274C>G, XM_011515390.1:c.-84-153C>G, XM_011515391.1:c.-274C>G, rs17777058, rs36215460, rs56588968, rs58302852
C > G
SNP
No VIP available No Clinical Annotations available VA
rs1801689 NC_000017.10:g.64210580A>C, NC_000017.11:g.66214462A>C, NG_012045.1:g.19977T>G, NM_000042.2:c.973T>G, NP_000033.2:p.Cys325Gly, XM_005257304.1:c.760T>G, XP_005257361.1:p.Cys254Gly, rs17690416, rs4791077, rs52792576
A > C
SNP
C325G
No VIP available No Clinical Annotations available VA
rs1801690 NC_000017.10:g.64208285C>G, NC_000017.11:g.66212167C>G, NG_012045.1:g.22272G>C, NM_000042.2:c.1004G>C, NP_000033.2:p.Trp335Ser, XM_005257304.1:c.791G>C, XP_005257361.1:p.Trp264Ser, rs17763527, rs8178862
C > G
SNP
W335S
No VIP available CA VA
rs187238 NC_000011.10:g.112164265C>G, NC_000011.9:g.112034988C>G, NG_028143.1:g.4853G>C, NM_001243211.1:c.-368G>C, NM_001562.3:c.-368G>C, XM_005271612.1:c.-24-4980C>G, XM_011542805.1:c.-389G>C, XM_011542806.1:c.-389G>C, rs17281504, rs3740967, rs57513680
C > G
SNP
No VIP available No Clinical Annotations available VA
rs1931704 NC_000010.10:g.129339809G>A, NC_000010.11:g.127541545G>A, rs59084502
G > A
SNP
No VIP available CA VA
rs1946518 NC_000011.10:g.112164735T>G, NC_000011.9:g.112035458T>G, NG_028143.1:g.4383A>C, NM_001243211.1:c.-838A>C, NM_001562.3:c.-838A>C, XM_005271612.1:c.-24-4510T>G, XM_011542805.1:c.-859A>C, XM_011542806.1:c.-859A>C, rs57159524
T > G
SNP
No VIP available No Clinical Annotations available VA
rs2066911 NC_000006.11:g.23548350G>A, NC_000006.12:g.23548122G>A, XR_926600.1:n.278+35982C>T, XR_926601.1:n.278+35982C>T, rs59102268
G > A
SNP
No VIP available CA VA
rs2228570 NC_000012.11:g.48272895A>G, NC_000012.12:g.47879112A>G, NG_008731.1:g.30920T>C, NM_000376.2:c.2T>C, NM_001017535.1:c.2T>C, NM_001017536.1:c.152T>C, NP_000367.1:p.Met1Thr, NP_001017535.1:p.Met1Thr, NP_001017536.1:p.Met51Thr, XM_006719587.2:c.2T>C, XM_011538720.1:c.2T>C, XP_006719650.1:p.Met1Thr, XP_011537022.1:p.Met1Thr, rs10735810, rs117559231, rs17881966, rs52811041, rs56641119, rs57067622, rs8179174
A > G
SNP
M1T
No VIP available No Clinical Annotations available VA
rs231775 NC_000002.11:g.204732714A>G, NC_000002.12:g.203867991A>G, NG_011502.1:g.5206A>G, NM_001037631.2:c.49A>G, NM_005214.4:c.49A>G, NP_001032720.1:p.Thr17Ala, NP_005205.2:p.Thr17Ala, XR_241294.1:n.189A>G, rs57563726
A > G
SNP
T17A
No VIP available No Clinical Annotations available VA
rs2660 NC_000012.11:g.113357442G>A, NC_000012.12:g.112919637G>A, NG_011530.2:g.17704G>A, NM_001032409.2:c.1189G>A, NM_001320151.1:c.1038+1937G>A, NM_016816.3:c.*84G>A, NP_001027581.1:p.Gly397Arg, XM_006719434.1:c.*924G>A, XM_011538413.1:c.1165G>A, XM_011538414.1:c.1038+1937G>A, XP_011536715.1:p.Gly389Arg, XR_944557.1:n.1330G>A, rs17834423, rs3168660, rs56511560, rs56662468, rs58192814
G > A
SNP
G397R
No VIP available CA VA
rs28416813 NC_000019.10:g.39245004C>G, NC_000019.9:g.39735644C>G, NG_042193.1:g.4968G>C, NM_172139.2:c.-37G>C, XM_005258765.1:c.11-35G>C, XM_005258765.3:c.11-35G>C, XM_011526757.1:c.11-35G>C
C > G
SNP
No VIP available No Clinical Annotations available VA
rs304478 NC_000010.10:g.91150922G>T, NC_000010.11:g.89391165G>T, NM_001270927.1:c.-1645G>T, NM_001270928.1:c.-1755G>T, NM_001270929.1:c.-1750G>T, NM_001270930.1:c.-1876G>T, NM_001548.4:c.-1548G>T, rs57082652, rs666227
G > T
SNP
No VIP available No Clinical Annotations available VA
rs3093390 NC_000016.10:g.27452127C>T, NC_000016.9:g.27463448C>T, NG_012222.1:g.54726C>T, NM_021798.3:c.*2844C>T, NM_181078.2:c.*2844C>T, NM_181079.4:c.*2844C>T, NR_037158.1:n.477+616G>A, rs61246140
C > T
SNP
No VIP available CA VA
rs368234815 NC_000019.10:g.39248514_39248515delTTinsG, NC_000019.9:g.39739154_39739155delTTinsG, NG_042193.1:g.1457_1458delAAinsC, NM_001276254.2:c.(65_?)delAAinsC, NP_001263183.2:p.Ala(22_?)_Ala22=, NR_074079.1:n.342_343delAAinsC, XM_011526757.1:c.-1963_-1962delAAinsC
TT > AA
TT > C
indel
No VIP available CA VA
rs3828913 NC_000006.11:g.31465795C>A, NC_000006.12:g.31498018C>A, NG_021405.1:g.4941C>A, NM_001289160.1:c.-27+3023C>A, NM_001289161.1:c.-176C>A, NM_005931.4:c.-176C>A, NT_113891.3:g.2975360C>A, NT_167244.1:g.2780502C>A, NT_167244.2:g.2830586C>A, NT_167245.2:g.2745626C>A, NT_167247.2:g.2839974C>A, NT_167248.2:g.2753918C>A, NT_167249.2:g.2797313C>A, XM_005249125.1:c.-27+3023C>A, XM_005249126.1:c.-176C>A, XM_005272818.1:c.-27+3024C>A, XM_005272819.1:c.-174C>A, XM_005274863.1:c.-27+3023C>A, XM_005274864.1:c.-176C>A, XM_005274975.1:c.-27+3039C>A, XM_005274976.1:c.-176C>A, XM_005275250.1:c.-27+3024C>A, XM_005275251.1:c.-174C>A, XM_005275408.1:c.-27+3030C>A, XM_005275409.1:c.-176C>A, XM_005275556.1:c.-27+3029C>A, XM_005275557.1:c.-176C>A, XM_006726002.2:c.-27+1118C>A, XM_006726095.2:c.-27+1118C>A, XM_011514630.1:c.-27+3042C>A, XM_011514631.1:c.-27+1118C>A, XM_011546312.1:c.-27+3042C>A, XM_011546313.1:c.-27+1118C>A, XM_011547251.1:c.-27+3043C>A, XM_011547252.1:c.-27+1118C>A, XM_011547655.1:c.-27+1118C>A, XM_011547656.1:c.-27+3039C>A, XM_011548052.1:c.-27+3043C>A, XM_011548053.1:c.-27+1118C>A, rs113943461, rs117394537, rs59761184
C > A
SNP
No VIP available CA VA
rs4803217 NC_000019.10:g.39243580C>A, NC_000019.9:g.39734220C>A, NG_042193.1:g.6392G>T, NM_172139.2:c.*52G>T, XM_005258765.1:c.*52G>T, XM_005258765.3:c.*52G>T, XM_011526757.1:c.*52G>T
C > A
SNP
No VIP available CA VA
rs4803219 NC_000019.10:g.39245279C>T, NC_000019.9:g.39735919C>T, NG_042193.1:g.4693G>A, NM_172139.2:c.-312G>A, XM_005258765.1:c.-202G>A, XM_005258765.3:c.-202G>A, XM_011526757.1:c.-202G>A, rs201690073
C > T
SNP
No VIP available No Clinical Annotations available VA
rs4969170 NC_000017.10:g.76360538A>G, NC_000017.11:g.78364457A>G, NG_016851.1:g.621T>C, NR_110845.1:n.462-40A>G, NR_110846.1:n.139-40A>G, NR_110847.1:n.405+1706A>G, XR_243763.1:n.396-40A>G, XR_243764.1:n.396-40A>G, rs59927390
A > G
SNP
No VIP available No Clinical Annotations available VA
rs52797880 NC_000017.10:g.64216854A>G, NC_000017.11:g.66220736A>G, NG_012045.1:g.13703T>C, NM_000042.2:c.422T>C, NP_000033.2:p.Ile141Thr, XM_005257304.1:c.422T>C, XP_005257361.1:p.Ile141Thr, rs117879669
A > G
SNP
I141T
No VIP available No Clinical Annotations available VA
rs557905 NC_000011.10:g.105027116T>C, NC_000011.9:g.104897843T>C, NG_029124.1:g.13015A>G, NM_001223.4:c.944-165A>G, NM_001257118.2:c.1007-165A>G, NM_001257119.2:c.944-165A>G, NM_033292.3:c.1007-165A>G, NM_033293.3:c.728-165A>G, NM_033294.3:c.584-165A>G, NM_033295.3:c.59-165A>G, XM_006718924.2:c.1139-165A>G, XM_011543017.1:c.1139-165A>G, XM_011543018.1:c.1076-165A>G, rs17447000, rs386599073, rs57025585
T > C
SNP
No VIP available No Clinical Annotations available VA
rs568910 NC_000011.10:g.105033843A>C, NC_000011.9:g.104904570A>C, NG_029124.1:g.6288T>G, NM_001223.4:c.274+365T>G, NM_001257118.2:c.274+365T>G, NM_001257119.2:c.274+365T>G, NM_033292.3:c.274+365T>G, NM_033293.3:c.58+581T>G, NM_033294.3:c.58+581T>G, NM_033295.3:c.58+581T>G, XM_006718924.2:c.406+365T>G, XM_011543017.1:c.406+365T>G, XM_011543018.1:c.406+365T>G, rs17103561, rs386599431, rs59645688
A > C
SNP
No VIP available CA VA
rs6051702 NC_000020.10:g.3251924A>C, NC_000020.11:g.3271278A>C, NG_031974.1:g.141386T>G, NM_001009984.2:c.2651-716T>G, XM_005260684.1:c.2648-716T>G, XM_005260684.2:c.2648-716T>G, XM_005260685.1:c.2258-716T>G, XM_005260687.1:c.896-716T>G, XM_005260687.3:c.896-716T>G, XM_006723556.2:c.2573-716T>G, XM_011529207.1:c.1673-716T>G, XM_011529208.1:c.896-716T>G, XR_244215.1:n.2664-716T>G, rs59587953, rs7265818
A > C
SNP
No VIP available No Clinical Annotations available VA
rs6806020 NC_000003.11:g.54974158T>C, NC_000003.12:g.54940131T>C, NM_001304389.1:c.-221-14916A>G, NM_018398.2:c.2450-28319T>C, XM_005265318.1:c.2432-28319T>C, XM_005265319.1:c.2450-28319T>C, XM_005265337.1:c.-221-14916A>G, XM_011533946.1:c.2306-28319T>C, XM_011533947.1:c.2450-28319T>C, XM_011533954.1:c.1025-28319T>C, XM_011533955.1:c.986-28319T>C, XR_245149.1:n.2509-28319T>C, XR_245150.1:n.2491-28319T>C, XR_427281.1:n.2571-28319T>C, XR_940472.1:n.2571-28319T>C, XR_940473.1:n.2571-28319T>C, rs17320221, rs60680655
T > C
SNP
No VIP available CA VA
rs7248668 NC_000019.10:g.39253181G>A, NC_000019.9:g.39743821G>A
G > A
SNP
No VIP available CA VA
rs7270101 NC_000020.10:g.3193893A>C, NC_000020.11:g.3213247A>C, NG_012093.1:g.8838A>C, NM_001267623.1:c.67-738A>C, NM_033453.3:c.124+21A>C, NM_181493.2:c.73+21A>C, NR_052000.1:n.224+21A>C, NR_052001.1:n.49-11A>C, NR_052002.1:n.316+21A>C, XM_006723564.2:c.124+21A>C, XM_006723565.2:c.67-738A>C, XM_011529234.1:c.124+21A>C, XM_011529235.1:c.124+21A>C
A > C
SNP
No VIP available No Clinical Annotations available VA
rs7512595 NC_000001.10:g.27857171A>G, NC_000001.11:g.27530660A>G, XR_947118.1:n.342A>G, rs60090255
A > G
SNP
No VIP available CA VA
rs760370 NC_000006.11:g.44200953A>G, NC_000006.12:g.44233216A>G, NG_042893.1:g.18712A>G, NM_001078174.1:c.1260-201A>G, NM_001078175.2:c.1260-201A>G, NM_001078176.2:c.1260-201A>G, NM_001078177.1:c.1260-201A>G, NM_001304462.1:c.1497-201A>G, NM_001304463.1:c.1386-201A>G, NM_001304465.1:c.1338-201A>G, NM_001304466.1:c.1335-201A>G, NM_004955.2:c.1260-201A>G, XM_005248875.1:c.1497-201A>G, XM_005248876.1:c.1389-201A>G, XM_005248876.3:c.1389-201A>G, XM_005248877.1:c.1386-201A>G, XM_005248878.1:c.1260-201A>G, XM_005248878.3:c.1260-201A>G, XM_005248879.1:c.1260-201A>G, XM_005248879.3:c.1260-201A>G, XM_005248880.1:c.1260-201A>G, XM_005248880.3:c.1260-201A>G, XM_005248881.1:c.1260-201A>G, XM_005248881.3:c.1260-201A>G, XM_005248882.1:c.1260-201A>G, XM_005248882.3:c.1260-201A>G, XM_011514341.1:c.1500-201A>G, rs59700015
A > G
SNP
No VIP available No Clinical Annotations available VA
rs7750468 NC_000006.11:g.118076984G>A, NC_000006.12:g.117755821G>A, rs60599329
G > A
SNP
No VIP available CA VA
rs8099917 NC_000019.10:g.39252525T>G, NC_000019.9:g.39743165T>G, rs60715659
T > G
SNP
No VIP available CA VA
rs8103142 NC_000019.10:g.39244466T>C, NC_000019.9:g.39735106T>C, NG_042193.1:g.5506A>G, NM_172139.2:c.209A>G, NP_742151.2:p.Lys70Arg, XM_005258765.1:c.221A>G, XM_005258765.3:c.221A>G, XM_011526757.1:c.221A>G, XP_005258822.1:p.Lys74Arg, XP_011525059.1:p.Lys74Arg
T > C
SNP
K70R
No VIP available CA VA
rs8105790 NC_000019.10:g.39241861T>C, NC_000019.9:g.39732501T>C, NG_042193.1:g.8111A>G
T > C
SNP
No VIP available CA VA
rs8113007 NC_000019.10:g.39252463A>T, NC_000019.9:g.39743103A>T
A > T
SNP
No VIP available No Clinical Annotations available VA
rs8178822 NC_000017.10:g.64225529G>T, NC_000017.11:g.66229411G>T, NG_012045.1:g.5028C>A, NM_000042.2:c.-32C>A, XM_005257304.1:c.-32C>A, rs17769656, rs386616016, rs60898032
G > T
SNP
No VIP available CA VA
rs9939609 NC_000016.10:g.53786615T>A, NC_000016.9:g.53820527T>A, NG_012969.1:g.87653T>A, NM_001080432.2:c.46-23525T>A, XM_011523313.1:c.46-23525T>A, XM_011523314.1:c.46-23525T>A, XM_011523315.1:c.46-23525T>A, XM_011523316.1:c.46-23525T>A, rs17817682, rs58374961, rs61046791
T > A
SNP
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • RBV
  • Ribavirin Triphosphate
  • Ribavirina [INN-Spanish]
  • Ribavirine [INN-French]
  • Ribavirinum [INN-Latin]
Trade Names
  • Copegus
  • RIBAV
  • RTC
  • RTCA
  • RTP
  • Rebetol
  • Rebetron
  • Rebretron
  • Ribamide
  • Ribamidil
  • Ribamidyl
  • Ribasphere
  • Ribavirin Capsules
  • Ribavirin-TP
  • Tribavirin
  • Varazid
  • Vilona
  • Viramid
  • Virazid
  • Virazole
  • Virazole 5'-triphosphate
Brand Mixture Names
  • Rebetron (Schering-Plough) (Ribavirin + Interferon alpha)

PharmGKB Accession Id

PA451241

Type(s):

Drug

Description

A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses.

Source: Drug Bank

Indication

For the treatment of chronic hepatitis C and for respiratory syncytial virus (RSV).

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Ribavirin is readily phosphorylated intracellularly by adenosine kinase to ribavirin mono-, di-, and triphosphate metabolites. Ribavirin triphosphate (RTP) is a potent competitive inhibitor of inosine monophosphate (IMP) dehydrogenase, viral RNA polymerase and messenger RNA (mRNA) guanylyltransferase (viral) and can be incorporated into RNA in RNA viral species.. Guanylyltranserase inhibition stops the capping of mRNA. These diverse effects result in a marked reduction of intracellular guanosine triphosphate (GTP) pools and inhibition of viral RNA and protein synthesis. Ribavirin is also incorporated into the viral genome causing lethal mutagenesis and a subsequent decrease in specific viral infectivity.

Source: Drug Bank

Pharmacology

Ribavirin is an anti-viral drug active against a number of DNA and RNA viruses. It is a member of the nucleoside antimetabolite drugs that interfere with duplication of the viral genetic material. The drug inhibits the activity of the enzyme RNA dependent RNA polymerase, due to it's resemblence to building blocks of the RNA molecules. The oral form is used in the treatment of hepatitis C, in combination with interferon drugs. The aerosol form is used to treat respiratory syncytial virus-related diseases in children. The primary serious adverse effect of ribavirin is hemolytic anemia, which may worsen preexisting cardiac disease.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. Results of in vitro studies using both human and rat liver microsome preparations indicated little or no cytochrome P450 enzyme-mediated metabolism of ribavirin, with minimal potential for P450 enzyme-based drug interactions. Ribavirin has two pathways of metabolism: (1) a reversible phosphorylation pathway in nucleated cells; and (2) a degradative pathway involving deribosylation and amide hydrolysis to yield a triazole carboxylic acid metabolite.

Source: Drug Bank

Absorption

Rapidly and extensively absorbed following oral administration. However, due to first-pass metabolism, the absolute bioavailability averages 64%.

Source: Drug Bank

Half-Life

9.5 hours

Source: Drug Bank

Toxicity

Side effects include "flu-like" symptoms, such as headache, fatigue, myalgia, and fever. The LD 50 in mice is 2 g/kg orally and is associated with hypoactivity and gastrointestinal symptoms (estimated human equivalent dose of 0.17 g/kg, based on body surface area conversion).

Source: Drug Bank

Clearance

Source: Drug Bank

Chemical Properties

Chemical Formula

C8H12N4O5

Source: Drug Bank

Isomeric SMILES

C1=NC(=NN1[C@H]2[C@@H]([C@@H]([C@H](O2)CO)O)O)C(=O)N

Source: Drug Bank

NC(=O)C1=NN(C=N1)[C@@H]1O[C@H](CO)[C@@H](O)[C@H]1O

Source: Drug Bank

Canonical SMILES

NC(=O)C1=NN(C=N1)[C@@H]1O[C@H]

Source: Drug Bank

Average Molecular Weight

244.2047

Source: Drug Bank

Monoisotopic Molecular Weight

244.080769514

Source: Drug Bank

SMILES

NC(=O)C1=NN(C=N1)[C@@H]1O[C@H](CO)[C@@H](O)[C@H]1O

Source: Drug Bank

InChI String

InChI=1S/C8H12N4O5/c9-6(16)7-10-2-12(11-7)8-5(15)4(14)3(1-13)17-8/h2-5,8,13-15H,1H2,(H2,9,16)/t3-,4-,5-,8-/m1/s1

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
ADK (source: Drug Bank )
ENPP1 (source: Drug Bank )
IMPDH1 (source: Drug Bank )
NT5C2 (source: Drug Bank )

Drug Interactions

Interaction Description
zalcitabine - ribavirin Ribavirin may increase the hepatotoxicity of zalcitabine. May cause lactic acidosis. MOnitor for lactic acidosis during concomitant therapy. (source: Drug Bank )

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to ribavirin: 132

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics of ribavirin-induced anemia in hepatitis C. Pharmacogenomics. 2016. Ampuero Javier, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Vitamin D pathway gene polymorphisms as predictors of hepatitis C virus-related mixed cryoglobulinemia. Pharmacogenetics and genomics. 2016. Cusato Jessica, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Association between IFNL4 rs368234815 polymorphism and sustained virological response in chronic hepatitis C patients undergoing PEGylated interferon/ribavirin therapy: A meta-analysis. Human immunology. 2016. Xie Xiao, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Children Treated With Pegylated Interferon alfa-2a ± Ribavirin for Chronic Hepatitis C. Journal of pediatric gastroenterology and nutrition. 2016. Schwarz Kathleen B, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Peginterferon Therapy in Children with Chronic Hepatitis C: A Nationwide, Multi-center Study in Japan, 2004-2013. Journal of pediatric gastroenterology and nutrition. 2016. Suzuki Mitsuyoshi, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Combined Effects of 2 Interleukin 28B Polymorphisms on the Therapeutic Outcome of Hepatitis C Patients With Circulating Cryoglobulins. Medicine. 2015. Bellanti Francesco, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Assessment of interleukin 28B genotype as a predictor of response to combined therapy with pegylated interferon plus ribavirin in HCV infected Egyptian patients. Cytokine. 2015. Fathy Mona M, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Predictive factors for 24 weeks sustained virologic response (SVR24) and viral relapse in patients treated with simeprevir plus peginterferon and ribavirin. Hepatology international. 2015. Nakayama Masahiko, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Role of ITPA and SLC28A2 genes in the prediction of anaemia associated with protease inhibitor plus ribavirin and peginterferon in hepatitis C treatment. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2015. Ampuero Javier, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Comparison of Functional Variants in IFNL4 and IFNL3 for Association with Hepatitis C Virus Clearance. Journal of hepatology. 2015. O'Brien Thomas R, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The relationships between IFNL4 genotype, intrahepatic interferon-stimulated gene expression and interferon treatment response differs in HCV-1 compared with HCV-3. Alimentary pharmacology & therapeutics. 2015. Holmes J A, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Daclatasvir plus peginterferon alfa and ribavirin for treatment-naive chronic hepatitis C genotype 1 or 4 infection: a randomised study. Gut. 2015. Hézode Christophe, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Interleukin 28B Polymorphism Predicts Treatment Outcome Among Egyptian Patients Infected With HCV Genotype 4. Hepato-gastroenterology. 2015. El-Bendary Mahmoud, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Response to treatment following recently acquired hepatitis C virus infection in a multicentre collaborative cohort. Journal of viral hepatitis. 2015. Doyle J S, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The complete title: The effect of interleukin-28B rs12979860 polymorphism on the therapeutic response of Moroccan patients with chronic hepatitis C. Gene. 2015. Nadia Kandoussi, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
VDR gene polymorphisms impact on anemia at 2 weeks of anti-HCV therapy: a possible mechanism for early RBV-induced anemia. Pharmacogenetics and genomics. 2015. Cusato Jessica, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Interferon-λ3 polymorphisms in pegylated-interferon-alpha plus ribavirin therapy for genotype-2 chronic hepatitis C. World journal of gastroenterology. 2015. Ishiguro Haruya, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
MHC class I-related chain B gene polymorphism is associated with virological response to pegylated interferon plus ribavirin therapy in patients with chronic hepatitis C infection. Biomedical reports. 2015. Asada Ayumi, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IL28B rs12980275 variant as a predictor of sustained virologic response to pegylated-interferon and ribavirin in chronic hepatitis C patients: A systematic review and meta-analysis. Clinics and research in hepatology and gastroenterology. 2015. Zheng Hao, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
PharmGKB summary: very important pharmacogene information for human leukocyte antigen B. Pharmacogenetics and genomics. 2015. Barbarino Julia M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Impact of IL28B, ITPA and PNPLA3 genetic variants on therapeutic outcome and progression of hepatitis C virus infection. Pharmacogenomics. 2015. Rembeck Karolina, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Association between CXCL10 and DPP4 Gene Polymorphisms and a Complementary Role for Unfavorable IL28B Genotype in Prediction of Treatment Response in Thai Patients with Chronic Hepatitis C Virus Infection. PloS one. 2015. Thanapirom Kessarin, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
ITPA Polymorphisms Are Associated with Hematological Side Effects during Antiviral Therapy for Chronic HCV Infection. PloS one. 2015. Maan Raoel, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Impact of IL28B, APOH and ITPA Polymorphisms on Efficacy and Safety of TVR- or BOC-Based Triple Therapy in Treatment-Experienced HCV-1 Patients with Compensated Cirrhosis from the ANRS CO20-CUPIC Study. PloS one. 2015. About Frédégonde, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Performance and Value of IFN-Lambda3 and IFN-Lambda4 Genotyping in Patients with Chronic Hepatitis C (CHC) Genotype 2/3 in a Real World Setting. PloS one. 2015. Wiegand Steffen B, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IL28B genotype predicts response to chronic hepatitis C triple therapy with telaprevir or boceprevir in treatment naïve and treatment-experienced patients other than prior partial- and null-responders. SpringerPlus. 2015. Calisti Giorgio, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Host Genetic Factors and Dendritic Cell Responses Associated with the Outcome of Interferon/Ribavirin Treatment in HIV-1/HCV Co-Infected Individuals. Journal of clinical & cellular immunology. 2014. Sehgal Mohit, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IL28B polymorphism genotyping as predictor of rapid virologic response during interferon plus ribavirin treatment in hepatitis C virus genotype 1 patients. World journal of gastroenterology : WJG. 2014. Rosso Chiara, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
KIR3DL1-HLA-Bw4 combination and IL28B polymorphism predict response to Peg-IFN and ribavirin with and without telaprevir in chronic hepatitis C. Human immunology. 2014. Umemura Takeji, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IFNL3 polymorphisms predict response to therapy in chronic hepatitis C genotype 2/3 infection. Journal of hepatology. 2014. Eslam Mohammed, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Simeprevir with pegylated interferon alfa 2a or 2b plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-2): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet (London, England). 2014. Manns Michael, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Strong prediction of virological response to combination therapy by IL28B gene variants rs12979860 and rs8099917 in chronic hepatitis C genotype 4. Liver international : official journal of the International Association for the Study of the Liver. 2014. Ragheb Mostafa M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Simeprevir with peginterferon and ribavirin leads to high rates of SVR in patients with HCV genotype 1 who relapsed after previous therapy: a phase 3 trial. Gastroenterology. 2014. Forns Xavier, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IFNL4-deltaG genotype is associated with slower viral clearance in hepatitis C, genotype-1 patients treated with sofosbuvir and ribavirin. The Journal of infectious diseases. 2014. Meissner Eric G, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IFNL4 polymorphism affects on outcome of telaprevir, peg-interferon and ribavirin combination therapy for chronic hepatitis C. Hepatology research : the official journal of the Japan Society of Hepatology. 2014. Nagaoki Yuko, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The novel ss469415590 variant predicts virological response to therapy in patients with chronic hepatitis C virus type 1 infection. Alimentary pharmacology & therapeutics. 2014. Covolo L, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IFNL4 ss469415590 variant is a better predictor than rs12979860 of pegylated interferon-alpha/ribavirin therapy failure in hepatitis C virus/HIV-1 coinfected patients. AIDS (London, England). 2014. Franco Sandra, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Polymorphisms of interferon-λ4 and IL28B - effects on treatment response to interferon/ribavirin in patients with chronic hepatitis C. Alimentary pharmacology & therapeutics. 2014. Stättermayer A F, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Impact of IL28B polymorphisms on 24-week telaprevir-based combination therapy for Asian chronic hepatitis C patients with hepatitis C virus genotype 1b. Journal of gastroenterology and hepatology. 2014. Tsubota Akihito, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Genetic polymorphism in IFNL4 and response to pegylated interferon-alpha and ribavirin in Japanese chronic hepatitis C patients. Tissue antigens. 2014. Nozawa Y, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Detection of allele specific differences in IFNL3 (IL28B) mRNA expression. BMC medical genetics. 2014. Knapp Susanne, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
FTO rs9939609 polymorphism is associated with metabolic disturbances and response to HCV therapy in HIV/HCV-coinfected patients. BMC medicine. 2014. Pineda-Tenor Daniel, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
IFNL4 ss469415590 Variant Is Associated with Treatment Response in Japanese HCV Genotype 1 Infected Individuals Treated with IFN-Including Regimens. International journal of hepatology. 2014. Miyamura Tatsuo, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Predictive value of the IFNL4 polymorphism on outcome of telaprevir, peginterferon, and ribavirin therapy for older patients with genotype 1b chronic hepatitis C. Journal of gastroenterology. 2013. Fujino Hatsue, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
IFNL4 ss469415590 Variant Shows Similar Performance to rs12979860 as Predictor of Response to Treatment against Hepatitis C Virus Genotype 1 or 4 in Caucasians. PloS one. 2014. Real Luis M, et al. PubMed
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Predictive value of interferon-lambda gene polymorphisms for treatment response in chronic hepatitis C. PloS one. 2014. Susser Simone, et al. PubMed
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Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for IFNL3 (IL28B) genotype and peginterferon alpha based regimens. Clinical pharmacology and therapeutics. 2013. Muir Andrew J, et al. PubMed
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Clinical milestones for the prediction of severe anemia by chronic hepatitis C patients receiving telaprevir-based triple therapy. Journal of hepatology. 2013. Ogawa Eiichi, et al. PubMed
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Effects of IL-28B gene polymorphism on response to peginterferon plus ribavirin combination therapy for genotype 2 chronic hepatitis C. Hepatology research : the official journal of the Japan Society of Hepatology. 2013. Shimoyama Yu, et al. PubMed
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Role of IL28B and inosine triphosphatase polymorphisms in the treatment of chronic hepatitis C virus genotype 6 infection. Journal of viral hepatitis. 2013. Seto W-K, et al. PubMed
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IL28B expression depends on a novel TT/-G polymorphism which improves HCV clearance prediction. The Journal of experimental medicine. 2013. Bibert Stéphanie, et al. PubMed
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Limited impact of IL28B genotype on response rates in telaprevir-treated patients with prior treatment failure. Journal of hepatology. 2013. Pol Stanislas, et al. PubMed
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Value of IL28B genotyping in patients with HCV-related mixed cryoglobulinemia: results of a large, prospective study. Journal of viral hepatitis. 2013. Piluso A, et al. PubMed
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HCV RNA decline in chronic HCV genotype 2 and 3 during standard of care treatment according to IL28B polymorphism. Journal of viral hepatitis. 2013. Stenkvist J, et al. PubMed
Human leukocyte antigen class I alleles can predict response to pegylated interferon/ribavirin therapy in chronic hepatitis C Egyptian patients. Archives of Iranian medicine. 2013. Farag Raghda E, et al. PubMed
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A variant upstream of IFNL3 (IL28B) creating a new interferon gene IFNL4 is associated with impaired clearance of hepatitis C virus. Nature genetics. 2013. Prokunina-Olsson Ludmila, et al. PubMed
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Association study of IL28B: rs12979860 and rs8099917 polymorphisms with SVR in patients infected with chronic HCV genotype 1 to PEG-INF/RBV therapy using systematic meta-analysis. Gene. 2013. Luo Yueqiu, et al. PubMed
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Influence of vitamin D-related gene polymorphisms (CYP27B and VDR) on the response to interferon/ribavirin therapy in chronic hepatitis C. PloS one. 2013. García-Martín Elena, et al. PubMed
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Factors that predict response of patients with hepatitis C virus infection to boceprevir. Gastroenterology. 2012. Poordad Fred, et al. PubMed
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Interleukin-28B (IL-28B) single-nucleotide polymorphisms and interferon plus ribavirin treatment outcome in Italian chronically HCV-infected patients. Journal of viral hepatitis. 2012. Riva E, et al. PubMed
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Impact of IL28B SNPs on therapeutic outcome and liver histology differs between hepatitis C virus genotypes. Pharmacogenomics. 2012. Lagging Martin. PubMed
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Association of two polymorphisms of the IL28B gene with viral factors and treatment response in 1,518 patients infected with hepatitis C virus. Journal of gastroenterology. 2012. Kobayashi Mariko, et al. PubMed
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HIV-1 antiretroviral drug therapy. Cold Spring Harbor perspectives in medicine. 2012. Arts Eric J, et al. PubMed
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IL28B polymorphism is associated with treatment response in patients with genotype 4 chronic hepatitis C. Journal of hepatology. 2012. Asselah Tarik, et al. PubMed
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IL28B polymorphisms do not predict response to therapy in chronic hepatitis C with HCV genotype 5. Gut. 2012. Antaki Nabil, et al. PubMed
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Interleukin 28B genetic polymorphisms and viral factors help identify HCV genotype-1 patients who benefit from 24-week pegylated interferon plus ribavirin therapy. Antiviral therapy. 2012. Liu Chen-Hua, et al. PubMed
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The Correlation of Il28B Genotype With Sustained Virologic Response In Romanian patients With Chronic Hepatitis C. Hepatitis monthly. 2011. Sporea Ioan, et al. PubMed
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Polymorphism near the IL28B gene in Korean hepatitis C virus-infected patients treated with peg-interferon plus ribavirin. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2011. Lyoo Kwangsoo, et al. PubMed
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Deciphering the interleukin 28B variants that better predict response to pegylated interferon-alpha and ribavirin therapy in HCV/HIV-1 coinfected patients. PloS one. 2012. de Castellarnau Montserrat, et al. PubMed
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Pharmacogenetics of efficacy and safety of HCV treatment in HCV-HIV coinfected patients: significant associations with IL28B and SOCS3 gene variants. PloS one. 2012. Vidal Francesc, et al. PubMed
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Genetic Variants of Interferon-Stimulated Genes and IL-28B as Host Prognostic Factors of Response to Combination Treatment for Chronic Hepatitis C. Clinical pharmacology and therapeutics. 2011. Lopez-Rodriguez R, et al. PubMed
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Association of interleukin 28B and mutations in the core and NS5A region of hepatitis C virus with response to peg-interferon and ribavirin therapy. Liver international : official journal of the International Association for the Study of the Liver. 2011. Hayashi Kazuhiko, et al. PubMed
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Antiviral combination therapy with peginterferon and ribavirin does not induce a therapeutically resistant mutation in the HCV core region regardless of genetic polymorphism near the IL28B gene. Journal of medical virology. 2011. Toyoda Hidenori, et al. PubMed
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IL28B rs12979860 C/T polymorphism in elderly chronic hepatitis C patients treated with pegylated-interferon and ribavirin. Alimentary pharmacology & therapeutics. 2011. Giannini E G, et al. PubMed
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IL28B polymorphisms associated with therapy response in Chilean chronic hepatitis C patients. World journal of gastroenterology : WJG. 2011. Venegas Mauricio, et al. PubMed
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Low-density lipoprotein receptor genotyping enhances the predictive value of IL28B genotype in HIV/hepatitis C virus-coinfected patients. AIDS (London, England). 2011. Pineda Juan A, et al. PubMed
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IL28B but not ITPA polymorphism is predictive of response to pegylated interferon, ribavirin, and telaprevir triple therapy in patients with genotype 1 hepatitis C. The Journal of infectious diseases. 2011. Chayama Kazuaki, et al. PubMed
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IL28B genetic variations are associated with high sustained virological response (SVR) of interferon-alpha plus ribavirin therapy in Taiwanese chronic HCV infection. Genes and immunity. 2011. Chen J-Y, et al. PubMed
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Common genetic polymorphism of ITPA gene affects ribavirin-induced anemia and effect of peg-interferon plus ribavirin therapy. Journal of medical virology. 2011. Azakami Takahiro, et al. PubMed
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Prediction of response to peginterferon-alfa-2b plus ribavirin therapy in Japanese patients infected with hepatitis C virus genotype 1b. Journal of medical virology. 2011. Hashimoto Yoshimasa, et al. PubMed
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Interleukin 28B gene variation at rs12979860 determines early viral kinetics during treatment in patients carrying genotypes 2 or 3 of hepatitis C virus. The Journal of infectious diseases. 2011. Lindh Magnus, et al. PubMed
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IL28B gene polymorphisms and viral kinetics in HIV/hepatitis C virus-coinfected patients treated with pegylated interferon and ribavirin. AIDS (London, England). 2011. Rallón Norma I, et al. PubMed
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Impact of IL28B polymorphisms on response to peginterferon and ribavirin in HIV-hepatitis C virus-coinfected patients with prior nonresponse or relapse. AIDS (London, England). 2011. Labarga Pablo, et al. PubMed
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Donor and recipient IL28B polymorphisms in HCV-infected patients undergoing antiviral therapy before and after liver transplantation. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2011. Coto-Llerena M, et al. PubMed
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The rs8099917 polymorphism, when determined by a suitable genotyping method, is a better predictor for response to pegylated alpha interferon/ribavirin therapy in Japanese patients than other single nucleotide polymorphisms associated with interleukin-28B. Journal of clinical microbiology. 2011. Ito Kiyoaki, et al. PubMed
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Early virologic response and IL28B polymorphisms in patients with chronic hepatitis C genotype 3 treated with peginterferon alfa-2a and ribavirin. Journal of hepatology. 2011. Scherzer Thomas-Matthias, et al. PubMed
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Vitamin D deficiency and a CYP27B1-1260 promoter polymorphism are associated with chronic hepatitis C and poor response to interferon-alfa based therapy. Journal of hepatology. 2011. Lange Christian Markus, et al. PubMed
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Association of IL28B variants with response to pegylated-interferon alpha plus ribavirin combination therapy reveals intersubgenotypic differences between genotypes 2a and 2b. Journal of medical virology. 2011. Sakamoto Naoya, et al. PubMed
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Impact of IL28B genotype on the early and sustained virologic response in treatment-naïve patients with chronic hepatitis C. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2011. Stättermayer Albert Friedrich, et al. PubMed
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Genetic variation in BCL-2 and response to interferon in hepatitis C virus type 4 patients. Clinica chimica acta; international journal of clinical chemistry. 2011. Shaker Olfat G, et al. PubMed
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IL28B genetic variation and treatment response in patients with hepatitis C virus genotype 3 infection. Hepatology (Baltimore, Md.). 2011. Moghaddam Amir, et al. PubMed
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Importance of IL28B gene polymorphisms in hepatitis C virus genotype 2 and 3 infected patients. Journal of hepatology. 2011. Sarrazin Christoph, et al. PubMed
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Predictive value of the IL28B polymorphism on the effect of interferon therapy in chronic hepatitis C patients with genotypes 2a and 2b. Journal of hepatology. 2011. Kawaoka Tomokazu, et al. PubMed
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Relationship between the interleukin-28b gene polymorphism and the histological severity of hepatitis C virus-induced graft inflammation and the response to antiviral therapy after liver transplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2011. Eurich Dennis, et al. PubMed
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Association of IL28B gene variations with mathematical modeling of viral kinetics in chronic hepatitis C patients with IFN plus ribavirin therapy. Proceedings of the National Academy of Sciences of the United States of America. 2011. Hsu Ching-Sheng, et al. PubMed
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Genomics and drug response. The New England journal of medicine. 2011. Wang Liewei, et al. PubMed
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HCV substitutions and IL28B polymorphisms on outcome of peg-interferon plus ribavirin combination therapy. Gut. 2011. Hayes C Nelson, et al. PubMed
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Influence of ITPA polymorphisms on decreases of hemoglobin during treatment with pegylated interferon, ribavirin, and telaprevir. Hepatology (Baltimore, Md.). 2011. Suzuki Fumitaka, et al. PubMed
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Inosine triphosphatase genetic variants are protective against anemia during antiviral therapy for HCV2/3 but do not decrease dose reductions of RBV or increase SVR. Hepatology (Baltimore, Md.). 2011. Thompson Alexander J, et al. PubMed
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Pharmacodynamics of PEG-IFN-[alpha]-2a and HCV response as a function of IL28B polymorphism in HIV/HCV-coinfected patients. Journal of acquired immune deficiency syndromes (1999). 2011. de Araujo Evaldo Stanislau Affonso, et al. PubMed
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Quantitation of pretreatment serum interferon-gamma-inducible protein-10 improves the predictive value of an IL28B gene polymorphism for hepatitis C treatment response. Hepatology (Baltimore, Md.). 2011. Darling Jama M, et al. PubMed
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Role of interleukin-28B polymorphisms in the treatment of hepatitis C virus genotype 2 infection in Asian patients. Hepatology (Baltimore, Md.). 2011. Yu Ming-Lung, et al. PubMed
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Genetic variation in interleukin-28B predicts SVR in hepatitis C genotype 1 Argentine patients treated with PEG IFN and ribavirin. Annals of hepatology. 2011. Ridruejo Ezequiel, et al. PubMed
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Association of genetic variation in IL28B with hepatitis C treatment-induced viral clearance in the Chinese Han population. Antiviral therapy. 2011. Liao Xiang-Wei, et al. PubMed
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IL28B genotype is associated with differential expression of intrahepatic interferon-stimulated genes in patients with chronic hepatitis C. Hepatology (Baltimore, Md.). 2010. Urban Thomas J, et al. PubMed
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Response prediction in chronic hepatitis C by assessment of IP-10 and IL28B-related single nucleotide polymorphisms. PloS one. 2011. Lagging Martin, et al. PubMed
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Modeling the probability of sustained virological response to therapy with pegylated interferon plus ribavirin in patients coinfected with hepatitis C virus and HIV. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2010. Medrano Jose, et al. PubMed
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Prediction of response to pegylated interferon plus ribavirin by IL28B gene variation in patients coinfected with HIV and hepatitis C virus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2010. Pineda Juan A, et al. PubMed
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ITPA polymorphism affects ribavirin-induced anemia and outcomes of therapy--a genome-wide study of Japanese HCV virus patients. Gastroenterology. 2010. Ochi Hidenori, et al. PubMed
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Variants in the ITPA gene protect against ribavirin-induced hemolytic anemia and decrease the need for ribavirin dose reduction. Gastroenterology. 2010. Thompson Alexander J, et al. PubMed
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Influence of a single nucleotide polymorphism at the main ribavirin transporter gene on the rapid virological response to pegylated interferon-ribavirin therapy in patients with chronic hepatitis C virus infection. The Journal of infectious diseases. 2010. Morello Judit, et al. PubMed
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An IL28B polymorphism determines treatment response of hepatitis C virus genotype 2 or 3 patients who do not achieve a rapid virologic response. Gastroenterology. 2010. Mangia Alessandra, et al. PubMed
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Hepatic ISG expression is associated with genetic variation in interleukin 28B and the outcome of IFN therapy for chronic hepatitis C. Gastroenterology. 2010. Honda Masao, et al. PubMed
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Amino acid substitution in hepatitis C virus core region and genetic variation near the interleukin 28B gene predict viral response to telaprevir with peginterferon and ribavirin. Hepatology (Baltimore, Md.). 2010. Akuta Norio, et al. PubMed
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Interleukin-28B polymorphism improves viral kinetics and is the strongest pretreatment predictor of sustained virologic response in genotype 1 hepatitis C virus. Gastroenterology. 2010. Thompson Alexander J, et al. PubMed
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Interleukin-28B genetic variants and hepatitis virus infection by different viral genotypes. Hepatology (Baltimore, Md.). 2010. Montes-Cano Marco Antonio, et al. PubMed
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Replicated association between an IL28B gene variant and a sustained response to pegylated interferon and ribavirin. Gastroenterology. 2010. McCarthy Jeanette J, et al. PubMed
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Association of a single nucleotide polymorphism near the interleukin-28B gene with response to hepatitis C therapy in HIV/hepatitis C virus-coinfected patients. AIDS (London, England). 2010. Rallón Norma I, et al. PubMed
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Genetic variation in IL28B is associated with chronic hepatitis C and treatment failure: a genome-wide association study. Gastroenterology. 2010. Rauch Andri, et al. PubMed
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ITPA gene variants protect against anaemia in patients treated for chronic hepatitis C. Nature. 2010. Fellay Jacques, et al. PubMed
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Functional polymorphisms in the interleukin-6 and serotonin transporter genes, and depression and fatigue induced by interferon-alpha and ribavirin treatment. Molecular psychiatry. 2009. Bull S J, et al. PubMed
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IL28B SNP rs8099917 is strongly associated with pegylated interferon-alpha and ribavirin therapy treatment failure in HCV/HIV-1 coinfected patients. PloS one. 2010. Aparicio Ester, et al. PubMed
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Genome-wide association of IL28B with response to pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C. Nature genetics. 2009. Tanaka Yasuhito, et al. PubMed
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IL28B is associated with response to chronic hepatitis C interferon-alpha and ribavirin therapy. Nature genetics. 2009. Suppiah Vijayaprakash, et al. PubMed
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Interleukin 18 promoter variants (-137G>C and -607C>A) in patients with chronic hepatitis C: association with treatment response. Journal of clinical immunology. 2009. Haas Stephan L, et al. PubMed
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Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature. 2009. Ge Dongliang, et al. PubMed
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Increase in serum bilirubin in HIV/hepatitis-C virus-coinfected patients on atazanavir therapy following initiation of pegylated-interferon and ribavirin. AIDS (London, England). 2008. Rodríguez-Nóvoa Sonia, et al. PubMed
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Identification and functional analysis of variants in the human concentrative nucleoside transporter 2, hCNT2 (SLC28A2) in Chinese, Malays and Indians. Pharmacogenetics and genomics. 2007. Li Linghui, et al. PubMed
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Genetic analysis and functional characterization of polymorphisms in the human concentrative nucleoside transporter, CNT2. Pharmacogenetics and genomics. 2005. Owen Ryan P, et al. PubMed
HLA class I B44 is associated with sustained response to interferon + ribavirin therapy in patients with chronic hepatitis C. The American journal of gastroenterology. 2003. Romero-Gómez Manuel, et al. PubMed
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Functional characterization in yeast of genetic variants in the human equilibrative nucleoside transporter, ENT1. Pharmacogenetics. 2003. Osato Douglas H, et al. PubMed
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Effect of interferon alpha-ribavirin bitherapy on cytochrome P450 1A2 and 2D6 and N-acetyltransferase-2 activities in patients with chronic active hepatitis C. Clinical pharmacology and therapeutics. 2002. Becquemont Laurent, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0004-0086-94
DrugBank:
DB00811
PDB:
RTP
KEGG Drug:
D00423
PubChem Compound:
37542
PubChem Substance:
178906
46505883
ChemSpider:
34439
HET:
RTP
Therapeutic Targets Database:
DNC001210
FDA Drug Label at DailyMed:
d370635f-5530-4d42-a019-d76b61639787

Clinical Trials

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