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Recent discoveries have highlighted the influence of host genomics on hepatitis C virus (HCV) infection outcomes. As a result, our views on hepatitis C pathogenesis and therapeutic approaches have been transformed. The recognition of the impact of single-nucleotide polymorphisms (SNPs) of the genes interleukin 28B (IL28B), inosine triphosphatase (ITPA) and low-density lipoprotein cholesterol receptor (LDLR) may lead to refinements in the pharmacogenomic prediction of antiviral response and drug-related toxicities and favour the discovery of new therapeutic targets for hepatitis C. Although the relevance of host genetics may be less in the setting of very potent new direct-acting antivirals (DAAs), genetic markers may continue to aid decision making regarding the length of therapy. Moreover, in several populations, such as HIV/HCV-coinfected patients, current therapy with peginterferon-α/ribavirin will continue in use for most patients, and thus host factors will retain their predictive value for treatment outcomes for a while.