Do we need controlled attenuation parameter adjustment for fibrosis estimation in nonalcoholic fatty liver disease patients?

strating that patients in the ION-3 trial with non-CC IL28B genotypes had lower sustained virological response (SVR) rates in the 8-week treatment arms (CC, 98.2%; CT, 95.1%; TT, 90.0%) when SVR was recalculated excluding patients with missing outcome data. In their current report, they incorporate patients from the ION-4 trial and conclude that relapse rates are higher in patients with IL28B CT (relative risk [RR], 2.74; 95% confidence interval [CI], 0.74-10.17) and TT (RR, 4.58; 95% CI, 1.26-16.56) genotypes compared to the CC genotype. The researchers suggest that IL28B genotype may explain disparities in SVR between black and nonblack patients treated with direct-acting antivirals (DAAs), particularly in the setting of shortened treatment duration. The researchers also suggest that IL28B genotype testing might be helpful in determining appropriate DAA regimen and duration. We would like to highlight the following important considerations: