year 17, Issue 2 (March - April 2023)                   Iran J Med Microbiol 2023, 17(2): 211-217 | Back to browse issues page


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El-Ansary M R M. Immunological Response and Prevalence of Occult HCV Genotype 4 Among Patients Receiving Direct-Acting Antiviral (DAA) Drugs: A Cross-Sectional Study. Iran J Med Microbiol 2023; 17 (2) :211-217
URL: http://ijmm.ir/article-1-1806-en.html
Department of Immunology and Medical Microbiology, Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt , Melansary2022@gmail.com
Abstract:   (1358 Views)

Background and Aim: Infection with the hepatitis C virus (HCV) is an endemic public health problem with long-term consequences, especially in Egypt. Egypt has one of the highest incidence rates of HCV worldwide. The current cross-sectional study aims to determine how prevalent occult HCV infection is and how it affects the individual's immune response.
Materials and Methods: The studied adult patients the study had chronic HCV infection and underwent a combination of sofosbuvir 400 mg plus daclatasvir 60 mg once daily ribavirin regimen for 12 weeks from March to September 2019. Quantitative real-time PCR was used to detect HCV-RNA in the plasma. In addition, Cytometric Bead Array (CBA) technique was used to assess cytokines levels.
Results: 31 participants from Misr University for Science and Technology University hospitals outpatient clinics were included in the study. The median levels of cytokines of the included patients were as follow: the median IL-6 was 6.56 (5.7- 7.9) pg./mL, and 19% of the patients had higher serum IL-6 levels. None of the patients had abnormal serum levels 28b. in addition, the median serum NF-κB was 232 (18.7- 609.89), and 29% had high serum NF-κB levels. Six (19.4%) patients had positive occult HCV infection. Patients with occult HCV infection exhibited significantly higher values of serum IL-6 (P<0.001), NF-κB (P<0.001), serum AST (P<0.001), ALT (P<0.001), albumin (P<0.001), and total bilirubin (P<0.001).
Conclusion: We support the evidence about the significant association between occult HCV infection and impaired immunological response in patients who achieved sustained viral response (SVR) following direct-acting antivirals (DAA) regimens.

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Type of Study: Original Research Article | Subject: Medical Virology
Received: 2022/07/4 | Accepted: 2023/01/29 | ePublished: 2023/03/30

References
1. Petruzziello A, Marigliano S, Loquercio G, Cozzolino A, Cacciapuoti C. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016;22(34):7824-40. [DOI:10.3748/wjg.v22.i34.7824] [PMID] [PMCID]
2. Cooke GS, Lemoine M, Thursz M, Gore C, Swan T, Kamarulzaman A, et al. Viral hepatitis and the Global Burden of Disease: a need to regroup. J Viral Hepat. 2013;20(9):600-1. [DOI:10.1111/jvh.12123] [PMID]
3. Mohamoud YA, Mumtaz GR, Riome S, Miller D, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis. BMC Infect Dis. 2013;13(1):288. [DOI:10.1186/1471-2334-13-288] [PMID] [PMCID]
4. Elgharably A, Gomaa AI, Crossey MME, Norsworthy PJ, Waked I, Taylor-Robinson SD. Hepatitis C in Egypt - past, present, and future. Int J Gen Med. 2017;10:1-6. [DOI:10.2147/IJGM.S119301] [PMID] [PMCID]
5. Ditah I, Ditah F, Devaki P, Ewelukwa O, Ditah C, Njei B, et al. The changing epidemiology of hepatitis C virus infection in the United States: National health and nutrition examination survey 2001 through 2010. J Hepatol. 2014;60(4):691-8. [DOI:10.1016/j.jhep.2013.11.014] [PMID]
6. Lu M, Li J, Rupp LB, Zhou Y, Holmberg SD, Moorman AC, et al. Changing trends in complications of chronic hepatitis C. Liver Int. 2018;38(2):239-47. [DOI:10.1111/liv.13501] [PMID] [PMCID]
7. de Oliveria Andrade LJ, D'Oliveira A, Melo RC, De Souza EC, Costa Silva CA, Paraná R. Association between hepatitis C and hepatocellular carcinoma. J Glob Infect Dis. 2009;1(1):33-7. [DOI:10.4103/0974-777X.52979] [PMID] [PMCID]
8. Bennett JE, Dolin R, Blaser MJ. Mandell, douglas, and bennett's principles and practice of infectious diseases E-book: Elsevier health sciences; 2019.
9. Geddawy A, Ibrahim YF, Elbahie NM, Ibrahim MA. Direct acting anti-hepatitis C virus drugs: clinical pharmacology and future direction. J Transl int Med. 2017;5(1):8-17. [DOI:10.1515/jtim-2017-0007] [PMID] [PMCID]
10. Ji F, Wei B, Yeo YH, Ogawa E, Zou B, Stave CD, et al. Systematic review with meta-analysis: effectiveness and tolerability of interferon-free direct-acting antiviral regimens for chronic hepatitis C genotype 1 in routine clinical practice in Asia. Aliment Pharmacol Ther. 2018;47(5):550-62. [DOI:10.1111/apt.14507] [PMID]
11. Wei B, Ji F, Yeo YH, Ogawa E, Stave CD, Dang S, et al. Systematic review and meta-analysis: real-world effectiveness of direct-acting antiviral therapies in chronic hepatitis C genotype 3 in Asia. BMJ Open Gastroenterol. 2018;5(1):e000209. [DOI:10.1136/bmjgast-2018-000209] [PMID] [PMCID]
12. Liang TJ, Ghany MG. Current and future therapies for hepatitis C virus infection. N Engl J Med. 2013;368(20):1907-17. [DOI:10.1056/NEJMra1213651] [PMID] [PMCID]
13. Castillo I, Rodríguez-Iñigo E, López-Alcorocho JM, Pardo M, Bartolomé J, Carreño V. Hepatitis C Virus Replicates in the Liver of Patients Who Have a Sustained Response to Antiviral Treatment. Clin Infect Dis. 2006;43(10):1277-83. [DOI:10.1086/508198] [PMID]
14. Hetta HF, Mehta MJ, Shata MTM. Gut immune response in the presence of hepatitis C virus infection. World J Immunol. 2014;4(2):52-62. [DOI:10.5411/wji.v4.i2.52]
15. Mekky MA, Sayed HI, Abdelmalek MO, Saleh MA, Osman OA, Osman HA, et al. Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study. Infect Drug Resist. 2019;12:273-9. [DOI:10.2147/IDR.S181638] [PMID] [PMCID]
16. Fallahi P, Ferri C, Ferrari SM, Corrado A, Sansonno D, Antonelli A. Cytokines and HCV-related disorders. Clin Dev Immunol. 2012;2012. [DOI:10.1155/2012/468107] [PMID] [PMCID]
17. Antonelli A, Ferrari SM, Ruffilli I, Fallahi P. Cytokines and HCV-related autoimmune disorders. Immunol Res. 2014;60(2):311-9. [DOI:10.1007/s12026-014-8569-1] [PMID]
18. Kim AY, Kuntzen T, Timm J, Nolan BE, Baca MA, Reyor LL, et al. Spontaneous Control of HCV Is Associated With Expression of HLA-B*57 and Preservation of Targeted Epitopes. Gastroenterology. 2011;140(2):686-96.e1. [DOI:10.1053/j.gastro.2010.09.042] [PMID] [PMCID]
19. Grakoui A, Shoukry NH, Woollard DJ, Han J-H, Hanson HL, Ghrayeb J, et al. HCV persistence and immune evasion in the absence of memory T cell help. Science. 2003;302(5645):659-62. [DOI:10.1126/science.1088774] [PMID]
20. Shoukry NH, Grakoui A, Houghton M, Chien DY, Ghrayeb J, Reimann KA, et al. Memory CD8+ T cells are required for protection from persistent hepatitis C virus infection. J Exp Med. 2003;197(12):1645-55. [DOI:10.1084/jem.20030239] [PMID] [PMCID]
21. Gad YZ, Mouas N, Abdel-Aziz A, Abousmra N, Elhadidy M. Distinct immunoregulatory cytokine pattern in Egyptian patients with occult Hepatitis C infection and unexplained persistently elevated liver transaminases. Asian J Transfus Sci. 2012;6(1):24-8. [DOI:10.4103/0973-6247.95046] [PMID] [PMCID]
22. Flynn JK, Dore GJ, Hellard M, Yeung B, Rawlinson WD, White PA, et al. Maintenance of Th1 hepatitis C virus (HCV)-specific responses in individuals with acute HCV who achieve sustained virological clearance after treatment. J Gastroenterol Hepatol. 2013 (11):1770-81. [DOI:10.1111/jgh.12265] [PMID] [PMCID]
23. Kandeel A, Genedy M, El-Refai S, Funk AL, Fontanet A, Talaat M. The prevalence of hepatitis C virus infection in Egypt 2015: implications for future policy on prevention and treatment. Liver Int. 2017;37(1):45-53. [DOI:10.1111/liv.13186] [PMID] [PMCID]
24. Scheel TKH, Rice CM. Understanding the hepatitis C virus life cycle paves the way for highly effective therapies. Nat Med. 2013;19(7):837-49. [DOI:10.1038/nm.3248] [PMID] [PMCID]
25. Abd Alla MDA, El Awady MK. Hepatitis C Virus RNA Strands Detection in Peripheral Blood Mononuclear Cells Legitimizes Virus Eradication in Negative Serum PCR Naïve and Post-treatment Patients. J Clin Transl Hepatol. 2017;5(1):1-8. [DOI:10.14218/JCTH.2016.00054] [PMID] [PMCID]
26. Hanno AFF, Mohiedeen KM, Alshayeb AF, Deghedy A. HCV RNA in peripheral blood mononuclear cells (PBMCs) as a predictor of the response to antiviral therapy in chronic hepatitis C. Alexandria J Med. 2014;50(4):317-22. [DOI:10.1016/j.ajme.2013.05.004]
27. Pawełczyk A, Kubisa N, Jabłońska J, Bukowska-Ośko I, Caraballo Cortes K, Fic M, et al. Detection of hepatitis C virus (HCV) negative strand RNA and NS3 protein in peripheral blood mononuclear cells (PBMC): CD3+, CD14+ and CD19+. Virol J. 2013;10(1):346. [DOI:10.1186/1743-422X-10-346] [PMID] [PMCID]
28. De Marco L, Gillio-Tos A, Fiano V, Ronco G, Krogh V, Palli D, et al. Occult HCV infection: an unexpected finding in a population unselected for hepatic disease. PloS One. 2009;4(12):e8128. [DOI:10.1371/journal.pone.0008128] [PMID] [PMCID]
29. Pham TNQ, Coffin CS, Michalak TI. Occult hepatitis C virus infection: what does it mean? Liver Int. 2010;30(4):502-11. [DOI:10.1111/j.1478-3231.2009.02193.x] [PMID]
30. Aboalam H, Rashed H-A, Mekky M, Nafeh H, Osman O. Prevalence of occult hepatitis C virus in patients with HCV-antibody positivity and serum HCV RNA negativity. Curr Med Res Pract. 2016;1(2):12-6. [DOI:10.4103/2357-0121.192539]
31. Yousif MM, Fakhr AE, Morad EA, Kelani H, Hamed EF, Elsadek HM, et al. prevalence of occult hepatitis c virus infection in patients who achieved sustained virologic response to direct-acting antiviral agents. Infez Med. 2018;26(3):237-43.
32. Abu Khadr NA, Nouh HH, Hanafi NF, Asser SL, Hussain YA. Secondary occult hepatitis C virus infection (HCV) in chronic HCV patients after treatment with sofosbuvir and daclatasvir. Int J Curr Microbiol App Sci. 2018;7(1):1357-65. [DOI:10.20546/ijcmas.2018.701.165]
33. Castillo I, Bartolomé J, Quiroga JA, Barril G, Carreño V. Diagnosis of occult hepatitis C without the need for a liver biopsy. J Med Virol. 2010;82(9):1554-9. [DOI:10.1002/jmv.21866] [PMID]
34. Cavalheiro Nde P, Filgueiras TC, Melo CE, Morimitsu SR, de Araújo ES, Tengan FM, et al. Detection of HCV by PCR in serum and PBMC of patients with hepatitis C after treatment. Braz J Infect Dis. 2007;11(5):471-4. [DOI:10.1590/S1413-86702007000500006] [PMID]
35. Radkowski M, Gallegos-Orozco JF, Jablonska J, Colby TV, Walewska-Zielecka B, Kubicka J, et al. Persistence of hepatitis C virus in patients successfully treated for chronic hepatitis C. Hepatology. 2005;41(1):106-14. [DOI:10.1002/hep.20518] [PMID]
36. Bernardin F, Tobler L, Walsh I, Williams JD, Busch M, Delwart E. Clearance of hepatitis C virus RNA from the peripheral blood mononuclear cells of blood donors who spontaneously or therapeutically control their plasma viremia. Hepatology. 2008;47(5):1446-52. [DOI:10.1002/hep.22184] [PMID]
37. Rahman MZ, Ahmed DS, Masud H, Parveen S, Rahman MA, Chowdhury MS, et al. Sustained virological response after treatment in patients with chronic hepatitis C infection--a five year follow up. Bangladesh Med Res Counc Bull. 2013;39(1):11-3. [DOI:10.3329/bmrcb.v39i1.15791] [PMID]
38. Sood A, Midha V, Mehta V, Sharma S, Mittal R, Thara A, et al. How sustained is sustained viral response in patients with hepatitis C virus infection? Indian J Gastroenterol. 2010;29(3):112-5. [DOI:10.1007/s12664-010-0006-3]

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