An advanced liver fibrosis did not abolish an Egyptian ethnicity as a favourable predictor for hepatitis C genotype 4 (HCV–GT4) outcome, that raises genetic issues.

Multiple databases were searched from inception up to 1 April, 2020 for all studies included Egyptians, whose were genotyped for Interleukin–28B (IL-B28) in the setting of HCV. The pooled odds ratios (ORs) were based on a fixed or random effect model as appropriate.

In total, 33 studies included 5,538 Egyptians from 9 governorates. Of these, 4088 patients had chronic HCV–GT4, 373 resolvers (spontaneously cleared the virus), and 1077 non-infected subjects. The pooled prevalence of CC and CT/TT rs12979860 genotypes among chronic HCV–GT4 were 32%, and 68%, respectively. The pooled sustained virologic response (SVR) was achieved in 54% of 2,622 patients received Pegylated-interferon and Ribavirin. Compared with chronic HCV-infected patients, the favorable CC genotype was over-represented in the healthy subjects (30% vs. 45%), and HCV resolvers (28% vs. 59%). The CC genotype carriers were two-times more likely to resist HCV infection (vs. CT/TT: OR=1.93, P<0.001), three-times (OR=3.31, P<0.001) to clear the virus spontaneously, and six-times to achieve interferon-induced SVR (OR_corrected=6.03; P<0.001). The rs8099917 TT carriers were associated with a higher rate of SVR (vs. wild GT/GG, 74% vs. 38%), with 3-fold probability achieving SVR (OR_corrected=3.42, P<0.001).

Polymorphisms near the IL-28B gene protect against infection and persistence of HCV, and predict SVR.