This week in BMC Medicine: individualizing treatment for hepatitis C, obesity and autoimmunity

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Around 150 million people worldwide are chronically infected with hepatitis C virus (HCV), and around a quarter of those infected develop liver cirrhosis. Treatment for HCV is only effective in some patients, and it is important to take a patient’s genotype into consideration to decide which treatment should be given.

A meta-analysis by Maria A Jimenez-Sousa and colleagues from Health Institute Carlos III published this week in BMC Medicine investigated how treatment outcome in HCV patients is affected by polymorphisms in the gene coding for interleukin-28 (IL28B). The authors found that these polymorphisms affect both interferon treatment efficacy and natural clearance of HCV infection, and that the most appropriate genetic marker depends on a patient’s ethnicity. This research highlights the importance of patient selection for hepatitis C treatment, which has been further emphasized this week with the discovery of a variant in Interferon Lambda 4, another cytokine-encoding gene that affects HCV infection clearance. Jimenez-Sousa and colleagues explained that:

“[knowing a hepatitis C patient’s genetic status] will help target interferon treatment to those who will benefit most, and play a substantial role in the selection of candidates for standard treatment versus triple therapy with direct-acting antivirals.”

This study is the first research article to be published as part of our Personalized medicine: genes, biomarkers and tailored treatment article collection, which covers recent advances in personalized medicine across all areas of medical science and clinical practice.

Advances in personalized therapy for obesity and autoimmunity have also been explored in review articles published in the article collection this week. Carel le Roux and colleagues review the health benefits of bariatric surgery for obese patients and discuss how candidates can be selected for best outcome. The authors also describe the challenges associated with personalizing bariatric surgery, concluding that multi-disciplinary clinical evaluation of each patient must be carried out to decide whether surgery is appropriate.

In the field of autoimmunity, Javier Martin and colleagues from the Technological Park of Health Sciences of Granada review recent advances in understanding the genetic basis of scleroderma, and discuss how genetic insights can be used to develop an individualized approach to monitoring and treatment.

While these articles highlight the tremendous progress that has been made across key medical disciplines, there are still some obstacles that must be overcome before personalized medicine can be applied in everyday clinical practice. In another research article published in our personalized medicine collection, Milo A Puhan and colleagues from Johns Hopkins Bloomberg School of Public Health investigated clinical practice guidelines (CPGs) for a range of chronic conditions, and found that only a small proportion of CPGs make risk-stratified treatment recommendations. This important study indicates that further work is required before CPGs take benefit and harm into account for individual patients. We should be optimistic about the recent progress made in personalized medicine, but appreciate that further work is required to translate these advances into routine clinical application.

The Personalized medicine: genes, biomarkers and tailored treatment article collection is still open for submissions, and pre-submission queries can be sent to bmcmedicineeditorial@biomedcentral.com.