Circulating E-selectin levels in chronic hepatitis C patients with normal or elevated transaminase before and after alpha-interferon treatment

Blood markers of endothelial dysfunction and their correlation to cerebrovascular reactivity in patients with chronic hepatitis C infection

Although liver cirrhosis and hepatocellular carcinoma are major consequences of hepatitis C (HCV), there has been an increasing number of studies examining extrahepatic manifestations, especially those caused by systemic chronic inflammation and metabolic complications that might predispose HCV patients to atherosclerosis and ischemic cerebrovascular disease (CVD). The aim of our study was to assess E-selectin, VCAM-1, ICAM-1 and VEGF-A serum levels in patients with chronic HCV infection and to correlate them with cerebrovascular reactivity. A blood sample was taken from eighteen patients with chronic hepatitis C infection and from the same number of healthy blood donors in the control group. The aim was to analyse markers of endothelial dysfunction and to correlate them with cerebrovascular reactivity expressed as breath-holding index (BHI) determined using transcranial color Doppler. The obtained results revealed significant differences between the groups in all endothelial markers except for the E selectin. While the ICAM-1 and sVCAM-1 were significantly increased in the hepatitis group, VEGF-A was significantly decreased. A significant reduction of 0.5 (95% CI 0.2, 0.8) in the mean BHI was found in the hepatitis group (mean BHI 0.64) compared to controls (mean BHI 1.10). No significant association between the BHI and any of the endothelial markers was found in the control group, while in the hepatitis group, the scatter plot of ICAM-1 vs BHI suggested that the association might be present. In conclusion, the results of this study confirm an association between a chronic HCV infection and altered cerebrovascular reactivity as well as higher levels of markers of endothelial activation (ICAM-1, VCAM-1) as possible indicators of an increased CVD risk.

Influence of pretransplant IFN-alpha therapy on interstitial fibrosis in renal allografts with hepatitis C virus infection

The aim of this study is to identify the influence of chronic HCV infection on development of interstitial fibrosis (IF) in renal allografts and evaluate if pretransplant interferon-alpha (IFN-alpha) therapy has an effect on IF. The development of IF and graft outcome were compared between anti-HCV positive (n = 28) and anti-HCV negative (n = 30) recipients. The influence of IFN-alpha therapy on IF and graft survival was compared between anti-HCV positive recipients who received pre-transplant IFN-alpha therapy (n = 15, group 1) and anti-HCV positive recipients who did not receive IFN-alpha therapy (n = 13, group 2). Recipients with anti-HCV antibodies had higher incidences of IF and shorter graft survival than did recipients without anti-HCV antibodies (p < 0.05 for both). Development of IF was higher in group 2 recipients, and patients in group 1 had longer graft survivals (p < 0.05 for both). Patients with positive HCV-RNA had higher grades of tubular TGF-beta1 expression than did patients with negative HCV-RNA (p < 0.05). Expression of tubular TGF-beta1 was lower in group 1 patients when compared with group 2 patients (p < 0.001). In conclusion, we suggested that HCV infection may have a triggering effect on the development of IF in renal allografts by augmenting renal expression of TGF-beta1.