Genetic Testing for Pegylated Interferon Alpha

David R. Nelson, M.D., and patient

David R. Nelson, M.D., visits with a patient.

At UF Health, liver specialists order an IL28B genetic test for patients with hepatitis C. The test helps physicians determine a patient’s likelihood of eliminating the hepatitis C virus and thus whether to initiate treatment with a pegylated interferon alpha-based drug regimen. Peg-interferon alpha is a medication that can be used in combination with other antiviral drugs to treat hepatitis C virus infection, such as ribavirin or boceprevir (Victrelis®). This medicine can be difficult for patients to tolerate.

The IL28B genetic test is often ordered prior to initiating treatment, and mainly for patients with the genotype 1 hepatitis C virus. Encoded by the IL28B gene, the IL28B protein helps the body mount an immune response against the hepatitis C virus. Information about a patient’s genes that influence IL28B, along with other clinical factors, helps doctors determine whether to initiate an interferon-based drug regimen.

The UF Health Precision Medicine Program collaborated with the UF Health hepatology team to create electronic medical record inbasket alerts when this test is ordered to support providers in interpreting the pharmacogenetic test results and implementing genotype-based treatment decisions. These alerts were implemented in July 2014. The clinical leads for the collaboration are David R. Nelson, M.D., and Patrick Horne, M.S.N., ARNP.