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Dhaouadi T, Riahi A, Ben Abdallah T, Gorgi Y, Sfar I. Impact of IL-10 gene promoter polymorphisms on treatment response in HCV patients: A systematic review, a meta-analysis, and a meta-regression. Int J Immunopathol Pharmacol 2024; 38:3946320241240705. [PMID: 38520313 PMCID: PMC10960981 DOI: 10.1177/03946320241240705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/26/2024] [Indexed: 03/25/2024] Open
Abstract
The impact of interleukin-10 (IL-10) gene promoter polymorphisms (SNPs) on treatment response in HCV patients was dissimilarly estimated. Hence, the aim of this meta-analysis was to robustly assess the effect of IL-10 SNPs on treatment response in HCV patients. An electronic literature search was carried out through PubMed, EMBASE, Web of science, and Scopus databases. Studies assessing the association between IL-10 polymorphisms and treatment response in HCV patients were included. Studies were excluded if genotype frequencies are not consistent with the Hardy-Weinberg Equilibrium (HWE) or in case of including patients with hepatitis B virus coinfection. Risk of bias in included studies was assessed using the Newcastle-Ottawa Scale. Meta-analyses were performed for the influence of IL-10 gene promoter SNPs (rs1800896 (-1082 A/G), rs1800871 (-819 C/T), and rs1800872 (-592 C/T)) and haplotypes on treatment response in HCV patients. Subgroup analyses, meta-regressions, publication bias assessment, and sensitivity analyses were also conducted. Overall, 32 studies with a total of 5943 HCV cases and 2697 controls were included in the present study. The -1082*G allele was significantly associated with increased risk of non-response (NR) to treatment, OR [95% CI] = 1.29 [1.1-1.51], p = .002. Besides, the rs1800872 -592*C allele was significantly associated with increased NR risk, OR [95% CI] = 1.22 [1.02-1.46], p = .03. Subgroup analysis showed that this association remained significant only in patients treated with PEG-IFN alone, p = .01. The -1082*G/-819*C/-592*C (GCC) haplotype was significantly associated with increased NR risk, OR [95% CI] = 1.62 [1.13-2.23], p = .009. Our results suggest that the IL-10 rs1800896 was associated with NR risk especially in North-African and Asian populations. Moreover, the IL-10 gene promoter -1082*G/-819*C/-592*C (GCC) haplotype which has been associated with higher production of IL-10, was significantly associated with increased NR risk.
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Affiliation(s)
- Tarak Dhaouadi
- Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Awatef Riahi
- Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Taïeb Ben Abdallah
- Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Yousr Gorgi
- Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Imen Sfar
- Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia
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Cecchin E, Posocco B, Mezzalira S, Appetecchia M, Toffoli G. The Role of Gender Pharmacogenetics in the Personalization of Drug Treatment. J Pharmacol Exp Ther 2023; 386:190-197. [PMID: 37001987 DOI: 10.1124/jpet.122.001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/21/2023] [Indexed: 07/20/2023] Open
Abstract
The use of pharmacogenetic guidelines in personalizing treatments has shown the potential to reduce interindividual variability in drug response by enabling genotype-matched dosing and drug selection. However, other important factors, such as patient gender, may interact strongly with pharmacogenetics in determining the individual profile of toxicity and efficacy but are still rarely considered when planning pharmacological treatment. The literature indicates that males and females respond differently to drugs, with women being at higher risk for toxicity and having different plasma exposure to drugs at standard doses. Recent studies have shown that pharmacogenetic variants may have different predictive value in different sexes, as in the case of treatment with opioids, angiotensin-converting enzyme inhibitors, or proton pump inhibitors. Of particular interest is the case of treatment with fluoropyrimidines for cancer. A significant increase in toxicity has been described in female patients, with a more pronounced effect of specific DPYD and TYMS polymorphisms also noted. This manuscript reviews the major findings in the field of sex-specific pharmacogenomics. SIGNIFICANCE STATEMENT: Interindividual variability in drug response is an emerging issue in pharmacology. The genetic profile of patients, as well as their gender, may play a role in the identification of patients more exposed to the risk of adverse drug reactions or poor efficacy. This article reviews the current state of research on the interaction between gender and pharmacogenetics in addressing interindividual variability.
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Affiliation(s)
- Erika Cecchin
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Bianca Posocco
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Silvia Mezzalira
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Marialuisa Appetecchia
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
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Chang ML, Liaw YF. Hepatitis B Flare in Hepatitis B e Antigen-Negative Patients: A Complicated Cascade of Innate and Adaptive Immune Responses. Int J Mol Sci 2022; 23:ijms23031552. [PMID: 35163476 PMCID: PMC8836007 DOI: 10.3390/ijms23031552] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 12/11/2022] Open
Abstract
Chronic hepatitis B virus (HBV) infection is a dynamic process involving interactions among HBV, hepatocytes, and the host immune system. The natural course of chronic hepatitis B (CHB) is divided into four chronological phases, including the hepatitis B e antigen (HBeAg)-positive and HBeAg-negative phases. During HBV flare, alanine aminotransferase (ALT) levels abruptly rise to >5× the upper limit of normal; this is thought to occur due to the immune response against an upsurge in serum HBV DNA and antigen levels. Hepatitis flares may occur spontaneously, during or after antiviral therapy, or upon immunosuppression or chemotherapy in both HBeAg-positive and HBeAg-negative patients. The clinical spectrum of HBV flares varies from asymptomatic to hepatic decompensation or failure. HBeAg seroconversion with ≥ 1 year of consolidation therapy is accepted as an endpoint of oral antiviral therapy in HBeAg-positive patients, but recommendations for treating HBeAg-negative patients differ. Thus, the management of HBeAg-negative patients has attracted increasing interest. In the current review, we summarize various types of HBV flares and the associated complex cascade of innate and adaptive immune responses, with a focus on HBeAg-negative CHB patients. Hopefully, this review will provide insight into immunopathogenesis to improve the management of HBV flares in HBeAg-negative CHB patients.
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Affiliation(s)
- Ming-Ling Chang
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
- Division of Hepatology, Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 8107); Fax: +886-3-3272236
| | - Yun-Fan Liaw
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
- Division of Hepatology, Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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Guenifi W, Gasmi A, Lacheheb A. Epidemiological and Clinical Factors Associated with Spontaneous Clearance of Hepatitis C Virus. Middle East J Dig Dis 2021; 13:321-327. [PMID: 36606021 PMCID: PMC9489441 DOI: 10.34172/mejdd.2021.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/28/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The risk of chronicity is high after acute hepatitis C. The infection remains limited and spontaneously resolves in an average of 30% of subjects. Such subjects are considered recovered and do not require any medical care. This study aims to evaluate the epidemiological and clinical factors associated with spontaneous viral clearance. METHODS We conducted a descriptive retrospective study on patients' files managed for a positive hepatitis C serology who benefited from the research of serum viral RNA by molecular biology. RESULTS The study collected 429 usable files. The mean age of the patients was 50.21 years, and the sex ratio was 0.98. Spontaneous viral clearance was estimated at 17.2%. The univariate analysis showed that clearance was significantly greater in subjects under the age of 50 years, patients without type 2 diabetes, patients co-infected with hepatitis B virus, patients with transfusion, and those diagnosed fortuitously. Multivariate analysis confirmed the relationship between diabetes and the circumstances of the diagnosis. The relationship in the case of hepatitis B co-infection was very close to the statistical significance level (p=0.055). CONCLUSION The presence of hepatitis B co-infection in patients with positive hepatitis C serology predicts a high probability of having spontaneous clearance. However, advanced age and the existence of a history of blood transfusion, type 2 diabetes or suggestive signs of liver damage are associated with persistent viremia.
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Affiliation(s)
- Wahiba Guenifi
- Department of infectious diseases, Faculty of medicine, University FERHAT Abbes, Setif 1-Algeria
,Corresponding Author: Wahiba Guenifi, PhD Address : Department of infectious diseases, Faculty of medicine, University FERHAT Abbes, Setif 1-Algeria Tel : 00213667339852 Fax : 0021336721637 Email :
| | - Abdelkader Gasmi
- Department of infectious diseases, Faculty of medicine, University FERHAT Abbes, Setif 1-Algeria
| | - Abdelmadjid Lacheheb
- Department of infectious diseases, Faculty of medicine, University FERHAT Abbes, Setif 1-Algeria
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Wang Y, Zhao Z, Zhang H, Lin Q, Wang N, Ngwanguong Hannah M, Rui J, Yang T, Li P, Mao S, Lin S, Liu X, Zhu Y, Xu J, Yang M, Luo L, Liu C, Li Z, Deng B, Huang J, Liu W, Zhao B, Su Y, Chen T. Estimating the transmissibility of hepatitis C: A modelling study in Yichang City, China. J Viral Hepat 2021; 28:1464-1473. [PMID: 34314082 DOI: 10.1111/jvh.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/22/2021] [Accepted: 06/26/2021] [Indexed: 12/09/2022]
Abstract
Yichang is a city in central China in the Hubei Province. This study aimed to estimate the dynamics of the transmissibility of hepatitis C using a mathematical model and predict the transmissibility of hepatitis C in 2030. Data of hepatitis C cases from 13 counties or districts (cities) in Yichang from 2008 to 2016 were collected. A susceptible-infectious-chronic-recovered (SICR) model was developed to fit the data. The transmissibility of hepatitis C at the counties or districts was calculated based on new infections (including infected or chronically infected cases) reported monthly in the city caused by one infectious individual (MNI). The trend of the MNI was fitted and predicted using 11 models, with the coefficient of determination (R2 ) was being used to test the goodness of fit of these models. A total of 3065 cases of hepatitis C were reported in Yichang from 2008 to 2016. The median MNI of Yichang was 0.0768. According to the fitting results and analysis, the trend of transmissibility of hepatitis C in Yichang City conforms with the logarithmic (R2 = 0.918, p < 0.001):MNI = 0.265-0.108 log(t) and exponential (R2 = 0.939, p < 0.001): MNI = 0.344e(-0.278t) models. Hence, the transmission of hepatitis C virus at the county level has a downward trend. In conclusion, the transmissibility of hepatitis C in Yichang has a downward trend. With the current preventive and control measures in place, the spread of hepatitis C can be controlled.
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Affiliation(s)
- Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Hao Zhang
- Yichang municipal Center for Disease Control and Prevention, Yichang City, China
| | - Qin Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Ning Wang
- Shenzhen Heng Sheng Hospital, Shenzhen City, China
| | | | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Tianlong Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Peihua Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Siying Mao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Shengnan Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Xingchun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Yuanzhao Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Jingwen Xu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Meng Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Li Luo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Chan Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Zhuoyang Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Bin Deng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Jiefeng Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Weikang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, China
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Mezzalira S, Toffoli G. The effects of sex on pharmacogenetically guided drug treatment. Pharmacogenomics 2021; 22:959-962. [PMID: 34545749 DOI: 10.2217/pgs-2021-0088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Tweetable abstract Sex-related pharmacogenetics is emerging area of research to better explain sex discrepancies in drug response. Sex pharmacogenetics should be considered an essential step for personalized medicine.
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Affiliation(s)
- Silvia Mezzalira
- Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, Aviano, 33081, Italy
| | - Giuseppe Toffoli
- Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, Aviano, 33081, Italy
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Rao H, Liu H, Wu E, Yang M, Feng B, Lin A, Fei R, Fontana RJ, Wei L, Lok AS. Comparison of clinical outcomes and impact of SVR in American and Chinese patients with chronic hepatitis C. JHEP Rep 2020; 2:100136. [PMID: 32715286 PMCID: PMC7369613 DOI: 10.1016/j.jhepr.2020.100136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/30/2020] [Accepted: 05/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background & Aims Chronic HCV infection is an important cause of hepatocellular carcinoma (HCC) and liver failure in the US but limited data are available in China. We compared the incidence of clinical outcomes among adults with chronic HCV infection in the US and China and examined factors associated with outcomes. Methods A parallel prospective study of 2 cohorts of patients with HCV RNA+ recruited in 1 site in the US (UMHS) and 3 sites (PUHSC) in China between September 2011 and July 2015 was carried out. Composite liver outcomes (liver-related deaths, HCC, liver transplantation or liver decompensation), were analysed using competing-risk Cox proportional hazards model to determine incidence and associated factors. Results A total of 795 UMHS and 854 PUHSC patients were followed for a median of 3.06 and 3.99 years, respectively. At enrolment, a significantly higher percentage of UMHS patients had cirrhosis (45.4% vs. 16.2%). The 5-year cumulative incidence of composite liver outcomes was significantly higher in UMHS than in PUHSC patients (25.3% vs. 6.6%, p <0.0001). Stratification by stage of liver disease at enrolment showed this difference persisted only in the subgroup without cirrhosis due to higher aspartate aminotransferase to platelet ratio index (APRI) in the UMHS cohort. A total of 493 UMHS and 502 PUHSC patients received HCV treatment, and sustained virologic response (SVR) was achieved in 88.0% UMHS and 86.8% PUHSC treated-patients. SVR as time-dependent variable was associated with 80% lower risk of composite liver outcomes among patients with decompensated cirrhosis but not the overall cohorts. Conclusions When accounting for disease severity at entry, the incidence of composite liver outcomes was similar in patients with HCV in the US and China. Achievement of SVR had the greatest short-term impact on patients with decompensated cirrhosis. Lay summary Patients with chronic hepatitis C virus infection were recruited from centres in the United States and China. During follow-up, a higher percentage of the American patients had clinical outcomes: liver failure, liver cancer, liver transplant or liver-related deaths than the Chinese patients, mainly because more American patients had cirrhosis at enrolment. Older age and more advanced liver disease were associated with higher incidence of outcomes overall and viral clearance after hepatitis C treatment was associated with a lower incidence of outcomes in patients with advanced cirrhosis. Our findings highlight the importance of improving diagnosis and treatment of hepatitis C before advanced liver disease develops. The incidence of clinical outcomes in US and Chinese patients with chronic HCV infection was compared. Outcome rates were higher in the US cohort, in which cirrhosis was more common. SVR rates were similar in the 2 cohorts. SVR decreased the incidence of clinical outcomes in patients with decompensated cirrhosis over a median 3-year follow-up.
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Key Words
- AFP, alpha fetoprotein
- AIC, Akaike Information Criterion
- ALB, albumin
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- APRI, aspartate aminotransferase to platelet ratio index
- AST, aspartate aminotransferase
- BMI, body mass index
- Cirrhosis
- DAA, direct-acting antiviral
- Decompensation
- Direct-acting antiviral therapy
- FIB-4, fibrosis-4
- HCC, hepatocellular carcinoma
- HCV, hepatitis C virus
- Hepatocellular carcinoma
- INR, international normalized ratio
- LT, liver transplantation
- LrD, liver-related deaths
- MELD, model for end-stage liver disease
- PUHSC, Peking University Health Science Center
- SVR, sustained virologic response
- TBIL, total bilirubin
- UMHS, University of Michigan Health System
- anti-HBc, antibody to HBcAg
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Affiliation(s)
- Huiying Rao
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Huixin Liu
- Department of Clinical Epidemiology and Biostatistics, Peking University People's Hospital, Beijing, China
| | - Elizabeth Wu
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Ming Yang
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Bo Feng
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Andy Lin
- The Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Ran Fei
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Robert J Fontana
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Lai Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Anna S Lok
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
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Hatanaka T, Naganuma A, Tateyama Y, Yoshinari F, Hoshino T, Sato K, Hmwe SS, Aizaki H, Wakita T, Kakizaki S, Uraoka T. Ledipasvir and Sofosbuvir for Acute Hepatitis C Virus Monoinfection Associated with a High Risk of Acute Liver Failure. Intern Med 2019; 58:2969-2975. [PMID: 31243225 PMCID: PMC6859401 DOI: 10.2169/internalmedicine.2982-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A 72-year-old Japanese man was referred to our hospital with yellow discoloration of the sclera and liver dysfunction. He was diagnosed with acute hepatitis C virus (HCV) infection on the basis of HCV-RNA positivity and anti-HCV seroconversion. A transjugular liver biopsy confirmed submassive hepatic necrosis. Five days after admission, no flapping tremor was observed, and the prothrombin time-international normalized ratio (PT-INR) and total bilirubin level showed increases of 1.70 and 17.8 mg/dL, respectively. The Model for End-Stage Liver Disease score was determined to be 25, and the risk of acute liver failure (ALF) was estimated to be 48% according to the Japan Hepatic Encephalopathy Prediction Model. Considering that rapid HCV clearance and temporary suppression of the immune response would prevent ALF, we prescribed oral ledipasvir (LDV) 90 mg and sofosbuvir (SOF) 400 mg for 12 weeks and intravenously injected methylprednisolone 1 g for 3 days. His PT-INR promptly improved, although the total bilirubin level increased to 30.3 mg/dL. Plasma bilirubin absorption was performed three times, and the total bilirubin level gradually decreased. HCV-RNA was still detectable at six weeks after the start of LDV/SOF therapy and finally undetectable at eight weeks. There were no adverse events associated with LDV/SOF. The patient was discharged 73 days after admission. A sustained virological response was achieved at 12 and 24 weeks after treatment. The findings from this case suggest that LDV/SOF therapy can be a promising option for acute HCV monoinfection associated with a high risk of ALF.
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Affiliation(s)
- Takeshi Hatanaka
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Japan
- Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Japan
| | - Atsushi Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Japan
| | - Yumeo Tateyama
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Japan
| | - Fukiko Yoshinari
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Japan
| | - Takashi Hoshino
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Japan
| | - Ken Sato
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Su Su Hmwe
- Department of Virology II, National Institute of Infectious Diseases, Japan
| | - Hideki Aizaki
- Department of Virology II, National Institute of Infectious Diseases, Japan
| | - Takaji Wakita
- Department of Virology II, National Institute of Infectious Diseases, Japan
| | - Satoru Kakizaki
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
| | - Toshio Uraoka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan
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Podlaha O, Wu G, Downie B, Ramamurthy R, Gaggar A, Subramanian M, Ye Z, Jiang Z. Genomic modeling of hepatitis B virus integration frequency in the human genome. PLoS One 2019; 14:e0220376. [PMID: 31356634 PMCID: PMC6663024 DOI: 10.1371/journal.pone.0220376] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022] Open
Abstract
Hepatitis B infection is a world-wide public health burden causing serious liver complications. Previous studies suggest that hepatitis B integration into the human genome plays a crucial role in triggering oncogenic process and may also constitutively produce viral antigens. Despite the progress in HBV biology and sequencing technology, our fundamental understanding of how many hepatocytes in the liver actually carry viral integrations is still lacking. Herein we provide evidence that the HBV virus integrates with a lower-bound frequency of 0.84 per diploid genome in hepatitis B positive hepatocellular cancer patients. Moreover, we calculate that integrated viral DNA generates ~80% of the HBsAg transcripts in these patients. These results underscore the need to re-evaluate the clinical end-point and treatment strategies for chronic hepatitis B patients.
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Affiliation(s)
- Ondrej Podlaha
- Gilead Sciences Inc., Foster City, CA, United States of America
| | - George Wu
- Gilead Sciences Inc., Foster City, CA, United States of America
| | - Bryan Downie
- Gilead Sciences Inc., Foster City, CA, United States of America
| | | | - Anuj Gaggar
- Gilead Sciences Inc., Foster City, CA, United States of America
| | | | - Zhishen Ye
- Gilead Sciences Inc., Foster City, CA, United States of America
| | - Zhaoshi Jiang
- Gilead Sciences Inc., Foster City, CA, United States of America
- * E-mail:
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Hepatitis C Virus Genetic Variability, Human Immune Response, and Genome Polymorphisms: Which Is the Interplay? Cells 2019; 8:cells8040305. [PMID: 30987134 PMCID: PMC6523096 DOI: 10.3390/cells8040305] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infection is the main cause of chronic hepatitis, affecting an estimated 150 million people worldwide. Initial exposure to HCV is most often followed by chronic hepatitis, with only a minority of individuals spontaneously clearing the virus. The induction of sustained and broadly directed HCV-specific CD4+ and CD8+ T cell responses, together with neutralizing antibodies (nAb), and specific genetic polymorphism have been associated with spontaneous resolution of the infection. However, due to its high variability, HCV is able to overwhelm the host immune response through the rapid acquisition of mutations in the epitopes targeted by T cells and neutralizing antibodies. In this context, immune-mediated pressure represents the main force in driving HCV evolution. This review summarizes the data on HCV diversity and the current state of knowledge about the contributions of antibodies, T cells, and host genetic polymorphism in driving HCV evolution in vivo.
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Ali Q, Jamal A, Imran M, Ullah S, Kalam I, Ullah S, Waqar AB. Correlation of IL28B rs12979860 genotype and gender with spontaneous clearance of HCV infection: a Pakistani cross-section study. Per Med 2018; 15:495-502. [PMID: 30398404 DOI: 10.2217/pme-2018-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM There is a strong correlation of IL28B rs12979860 genetic variations and gender with spontaneous clearance of hepatitis C virus (HCV) infection. MATERIALS & METHODS HCV-infected subjects were categorized into HCV spontaneous clearance (SC) group and chronic hepatitis C (CHC) group on the basis of anti-HCV antibodies and HCV RNA level and follow-up of 6 months. 35 subjects were classified in SC group and 165 subjects were classified in CHC group. IL28B rs12979860 genotypes were determined by allele-specific PCR. RESULTS & CONCLUSION Multinominal logistic regression analyses revealed that both genders favor IL28B rs12979860 CT genotype (OR: 4.80; CI: 2.22-10.35; p = 0.0005) and (OR: 3.47; CI: 1.63-7.43; p = 0.001) for male and female, respectively, are significant in spontaneous clearance of HCV infection.
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Affiliation(s)
- Qaisar Ali
- Faculty of Allied and Health Sciences, Imperial College of Business & Studies, Lahore, Pakistan 53720
| | - Arshad Jamal
- Faculty of Allied and Health Sciences, Imperial College of Business & Studies, Lahore, Pakistan 53720
| | - Muhammad Imran
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan 54000
| | - Sajjad Ullah
- Faculty of Allied and Health Sciences, Imperial College of Business & Studies, Lahore, Pakistan 53720
| | - Irfan Kalam
- Faculty of Allied and Health Sciences, Imperial College of Business & Studies, Lahore, Pakistan 53720
| | - Shafi Ullah
- Faculty of Allied and Health Sciences, Imperial College of Business & Studies, Lahore, Pakistan 53720
| | - Ahmed B Waqar
- Faculty of Allied and Health Sciences, Imperial College of Business & Studies, Lahore, Pakistan 53720
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Misra S, Dieterich DT, Saberi B, Kushner T. Direct-acting antiviral treatment of acute hepatitis C virus infections. Expert Rev Anti Infect Ther 2018; 16:599-610. [PMID: 30067402 DOI: 10.1080/14787210.2018.1505502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Hepatitis C contributes to significant morbidity and mortality worldwide. AHCV is defined as documented infection within 6 months of exposure. Treating acute hepatitis C virus (AHCV) with direct-acting antiviral agents in persons who inject drugs, HIV-positive men who have sex with men, and patients who acquire HCV nosocomially can contribute to the elimination of disease globally, preclude the morbidity and mortality of chronic disease, and prevent further transmission. Areas covered: In this review, we describe the epidemiology of AHCV, its natural history, the considerations involved in the decision of whether to treat AHCV, and the most current DAA therapy guidelines. PubMed was queried using key words and bibliographies were evaluated for relevant articles. Expert commentary: Despite the obvious benefits of AHCV treatment, clinical management is limited by the ability to identify asymptomatic cases and the absence of fully supported guidelines. However, clinical research is advancing and identifying specific regimens, decreasing treatment durations, and creating strategies to target at risk groups and screen for AHCV.
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Affiliation(s)
- Suresh Misra
- a Division of Liver Diseases, Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Douglas T Dieterich
- a Division of Liver Diseases, Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Behnam Saberi
- a Division of Liver Diseases, Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Tatyana Kushner
- a Division of Liver Diseases, Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Xie Z, Li Y, Long L, Liang H, Cai W, Shen T. Polymorphisms in the Th17 cell-related RORC gene are associated with spontaneous clearance of HCV in Chinese women. BMC Infect Dis 2018; 18:254. [PMID: 29866105 PMCID: PMC5987631 DOI: 10.1186/s12879-018-3153-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 05/18/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Female gender and favorable IFNL3 genotypes are the primary independent predictors of spontaneous clearance of HCV infection. However, chronic hepatitis C infection occurs in numerous women carrying favorable IFNL3 genotypes, indicating that other host and/or virological factors contribute to the prognosis of infection. METHODS A cohort of 137 anti-HCV-positive female Han Chinese cases, including 64 chronic HCV carriers and 73 HCV spontaneous resolvers, was recruited in the study. 111 SNPs in 23 genes encoding HCV co-receptors, transcription factors, Toll-like receptors, co-stimulating molecules, and cytokines were selected for SNP analysis. RESULTS After comparison of genotypes and allelotype frequencies of 111 SNPs in 23 genes in the primary cohort, the SNPs rs9826 (P = 0.024 for CC/TT/CT; P = 0.015 for C allele/T allele) and rs1521177 (P = 0.017 for GG/TT/GT; P = 0.006 for G allele/T allele) in the RORC gene were significantly associated with spontaneous HCV clearance. In the sub-cohort carrying favorable IFNL3 genotypes (rs12979860CC, rs8099917 TT, rs12980275 AA), rs1521177 (genotype: P = 0.040; allelotype: P = 0.021) remained significantly associated with spontaneous HCV clearance. Importantly, the most common RORC haplotype rs9826-T/rs1521177-T was presented at significantly different frequencies in resolvers and carriers in both the primary cohort (P = 0.0027) and the IFNL3 favorable sub-cohort (P = 0.0117). CONCLUSIONS This study indicates that genetic polymorphisms in human Th17-related RORC gene are associated with different natural prognosis of HCV infection. The RORC haplotype, rs9826-T/rs1521177-T, was favorable for spontaneous clearance of HCV infection.
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Affiliation(s)
- Zhe Xie
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University, Beijing, 100191 China
| | - Yuantao Li
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University, Beijing, 100191 China
| | - Lu Long
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University, Beijing, 100191 China
| | - Hua Liang
- State Key laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, China CDC, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, 510060 Guangdong China
| | - Tao Shen
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University, Beijing, 100191 China
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14
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Aisyah DN, Shallcross L, Hully AJ, O'Brien A, Hayward A. Assessing hepatitis C spontaneous clearance and understanding associated factors-A systematic review and meta-analysis. J Viral Hepat 2018; 25:680-698. [PMID: 29345844 DOI: 10.1111/jvh.12866] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/14/2017] [Indexed: 12/11/2022]
Abstract
New advances in the treatment of hepatitis C provide high levels of sustained viral response but their expense limits availability in publicly funded health systems. The aim of this review was to estimate the proportion of patients who will spontaneously clear HCV, to identify factors that are associated with clearance and to support better targeting of directly acting antivirals. We searched Ovid EMBASE, Ovid MEDLINE and PubMed from 1 January 1994 to 30 June 2015 for studies reporting hepatitis C spontaneous clearance and/or demographic, clinical and behavioural factors associated with clearance. We undertook meta-analyses to estimate the odds of clearance for each predictor. Forty-three studies met the inclusion criteria, representing 20 110 individuals, and 6 of these studies included sufficient data to estimate spontaneous clearance. The proportion achieving clearance within 3, 6, 12 and 24 months following infection were, respectively, 19.8% (95% CI: 2.6%-47.5%), 27.9% (95% CI: 17.2%-41.8%), 36.1% (95% CI: 23.5%-50.9%) and 37.1% (95% CI: 23.7%-52.8%). Individuals who had not spontaneously cleared by 12 months were unlikely to do so. The likelihood of spontaneous clearance was lower in males and individuals with HIV co-infection, the absence of HBV co-infection, asymptomatic infection, black or nonindigenous race, nongenotype 1 infection, older age and alcohol or drug problems. This study suggests that patients continue to spontaneously clear HCV for at least 12 months following initial infection. However, injecting drug users are comparatively less likely to achieve clearance; thus, they should be considered a priority for early treatment given the continuing risks that these individuals pose for onwards transmission.
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Affiliation(s)
- D N Aisyah
- UCL Infectious Disease Informatics, Farr Institute of Health Informatics, London, UK.,Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - L Shallcross
- UCL Infectious Disease Informatics, Farr Institute of Health Informatics, London, UK
| | - A J Hully
- Kings College London School of Medicine, London, UK
| | - A O'Brien
- UCL Division of Medicine, London, UK
| | - A Hayward
- UCL Infectious Disease Informatics, Farr Institute of Health Informatics, London, UK.,Institute of Epidemiology and Health Care, University College London, London, UK
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Nguyen LT, Van Nguyen D, Carr MJ, Hall WW, Nguyen LA. Association of interferon lambda polymorphisms with elevated baseline viral loads in chronic hepatitis C virus genotype 6 infection. Arch Virol 2018; 163:115-124. [PMID: 29022122 DOI: 10.1007/s00705-017-3583-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 08/22/2017] [Indexed: 12/24/2022]
Abstract
Globally, hepatitis C virus (HCV) is one of the major causes of hepatocellular carcinoma and liver cirrhosis. For clinical decision making, genetic variation in the interferon-λ (IFNL) cluster has been utilised as a baseline predictor of natural and interferon-based treatment-induced viral clearance. In Vietnam, where HCV genotypes 1 (g1) and g6 predominate, no prior studies have been conducted investigating associations of IFNL3/4 polymorphisms with spontaneous clearance (SC) or HCV viral load (VL) in chronic infection. In this study, we have investigated the host genetic variations in IFNL loci to determine the association of IFNL3/4 polymorphisms with HCV SC and baseline VLs in a Vietnamese HCV-seropositive cohort. The majority of the cohort harboured major homozygous polymorphisms in IFNL3/4 cluster (i.e. rs12979860-CC: 82.7%; rs8099917-TT: 84.8% and rs368234815-TT/TT: 85.5%) and the SC rates in these groups were 15.8%, 16.3% and 15.7%, respectively. In the minor allele groups, the resolution rates were lower (12% in rs12979860 non-CC, 9.1% in rs8099917 non-TT and 9.5% in rs368234815 non-TT/TT). Furthermore, in individuals harbouring minor alleles, females achieved higher SC rates than males. HCV g6-infected rs12979860 major homozygous individuals had significantly higher viral loads than individuals with minor alleles (CC: 6.56 log IU/ml vs. non-CC: 5.66 log IU/ml; P = 0.021). The association between IFNL3/4 genotypes with elevated HCV VL observed in HCV g6-infected individuals may have implications for the progression of liver disease in Southeast Asian countries where this viral genotype predominates and therefore warrants further studies.
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Affiliation(s)
- Linh Thuy Nguyen
- Laboratory of Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
- Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20, W10, Kita-ku, Sapporo, 001-0020, Japan.
| | - Dzung Van Nguyen
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Michael J Carr
- Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20, W10, Kita-ku, Sapporo, 001-0020, Japan
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - William W Hall
- Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20, W10, Kita-ku, Sapporo, 001-0020, Japan
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Lan Anh Nguyen
- Laboratory of Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
- Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20, W10, Kita-ku, Sapporo, 001-0020, Japan
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Nițescu M, Vâjâitu C, Săndulescu O, Streinu-Cercel A, Pițigoi D, Preoțescu LL, Streinu-Cercel A. Non-invasive quantification of liver fibrosis regression following successful treatment of chronic hepatitis C with direct acting antivirals. REV ROMANA MED LAB 2017. [DOI: 10.1515/rrlm-2017-0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Abstract
Introduction. The past years have revolutionized the treatment of hepatitis C virus (HCV) infection, with high rates of sustained virologic response (SVR). Furthermore, liver fibrosis has recently been redefined as a dynamic, reversible process. Methods. We performed a prospective cohort study to assess the role of laboratory evaluations and non-invasive measurement of liver stiffness in establishing the right time for starting treatment and in assessing the regression of liver fibrosis in Romanian patients treated with direct acting antivirals (DAA) for genotype 1b chronic hepatitis C. Results. We present the results for 102 patients, with a mean age of 58.5 years, and a rate of SVR of 100%. Our study has ruled out older age (p=0.628), IL28B non-CC genotype (p=0.693), baseline viral load above the cutoff of 600,000 IU/mL (p=0.353), and the presence of diabetes mellitus (p=0.272) or baseline steatosis (p=0.706) as factors potentially influencing the regression of liver fibrosis following DAA treatment of HCV infection with the 3D regimen. The quantitative regression of liver stiffness was inversely correlated with the duration of HCV infection (p=0.017), suggesting that timely treatment might associate better outcomes in terms of liver fibrosis. Conclusion. Our study’s results point towards the need to start DAA treatment earlier in patients with HCV infection.
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Affiliation(s)
- Maria Nițescu
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest , Romania
| | - Cristina Vâjâitu
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest , Romania
| | - Adrian Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest , Romania
| | - Daniela Pițigoi
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest , Romania
| | - Liliana Lucia Preoțescu
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest , Romania
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest , Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest , Romania
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Pasternak AL, Ward KM, Luzum JA, Ellingrod VL, Hertz DL. Germline genetic variants with implications for disease risk and therapeutic outcomes. Physiol Genomics 2017; 49:567-581. [PMID: 28887371 PMCID: PMC5668651 DOI: 10.1152/physiolgenomics.00035.2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Genetic testing has multiple clinical applications including disease risk assessment, diagnosis, and pharmacogenomics. Pharmacogenomics can be utilized to predict whether a pharmacologic therapy will be effective or to identify patients at risk for treatment-related toxicity. Although genetic tests are typically ordered for a distinct clinical purpose, the genetic variants that are found may have additional implications for either disease or pharmacology. This review will address multiple examples of germline genetic variants that are informative for both disease and pharmacogenomics. The discussed relationships are diverse. Some of the agents are targeted for the disease-causing genetic variant, while others, although not targeted therapies, have implications for the disease they are used to treat. It is also possible that the disease implications of a genetic variant are unrelated to the pharmacogenomic implications. Some of these examples are considered clinically actionable pharmacogenes, with evidence-based, pharmacologic treatment recommendations, while others are still investigative as areas for additional research. It is important that clinicians are aware of both the disease and pharmacogenomic associations of these germline genetic variants to ensure patients are receiving comprehensive personalized care.
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Affiliation(s)
- Amy L Pasternak
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Kristen M Ward
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Jasmine A Luzum
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Vicki L Ellingrod
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Daniel L Hertz
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
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18
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Jang TY, Lin PC, Huang CI, Liao YM, Yeh ML, Zeng YS, Liang PC, Hsu WY, Tsai SP, Lin ZY, Chen SC, Huang JF, Dai CY, Huang CF, Chiou SS, Chuang WL, Yu ML. Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients. PLoS One 2017; 12:e0178883. [PMID: 28598970 PMCID: PMC5466320 DOI: 10.1371/journal.pone.0178883] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/19/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND/AIMS Transfusion dependent subjects are at a great risk of viral hepatitis infection. We aimed to evaluate the prevalence and factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among transfusion-dependent patients in Taiwan. METHODS A total of 140 patients (67 thalassemic patients, 70 hemophilic patients, two patients with hereditary spherocytosis and one patient with von Willebrand disease) were prospectively enrolled to evaluate the prevalence and factors associated with viral hepatitis and spontaneous HCV clearance. All patients were tested for HBV and HCV serology and virology. Two consecutive serum samples, at least 1 year apart, were collected to clarify HCV seroclearance. RESULTS The seropositivity rate of hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV), and both HBsAg/anti-HCV were 6.4%, 45.7% and 5%, respectively. Logistic regression analysis of factors associated with anti-HCV seropositivity included age (odds ratio/95% confidence interval [OR/CI]: 1.12/1.07-1.18, P<0.001), serum alanine aminotransferase (ALT) (OR/CI: 1.04/1.02-1.06, P<0.001) and platelet counts (OR/CI: 0.995/0.991-0.998, P = 0.002). Age was the only factor independently associated with HBsAg seropositivity (OR/CI: 1.08/1.02-1.14.4, P = 0.007). Compared to patients born before 1992, the seroprevalence of HCV among thalassemic patients decreased dramatically in those born after 1992 (46.0% vs. 11.8%, p = 0.012). The seroprevalence of HCV among hemophilic patients also decreased significantly when comparing patients born before 1987 to those born after 1987 (79.5% vs. 11.5%, p<0.001). Similarly, the seroprevalence of HBV decreased significantly in the post-vaccination cohort compared to its counterpart (13.1%, vs. 1.3%, p = 0.005). The spontaneous clearance of HCV was observed in 25.4% (15/59) of patients, and ALT was the only factor associated with it (OR/CI 0.98/0.96-1.00, P = 0.02). CONCLUSIONS Both HBV and HCV infections are prevalent among transfusion-dependent thalassemic and hemophilic patients in Taiwan. Nevertheless, seroprevalence decreased significantly and dramatically for HCV after universal blood screening and for HBV after implementation of a universal mass vaccination program.
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Affiliation(s)
- Tyng-Yuan Jang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Chin Lin
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-I Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Mei Liao
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Sheng Zeng
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Po-Cheng Liang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Yi Hsu
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Pien Tsai
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Zu-Yau Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shinn-Cherng Chen
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shyh-Shin Chiou
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Liver Center, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Novotny D, Roubalova L, Aiglova K, Bednarikova J, Bartkova M. IL28B genotyping and treatment of HCV infected subjects. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0804.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AbstractBackground: Chronic hepatitis C is a common cause of advanced liver disease and appropriate treatment has been complex and a challenge. Reaction of individual genotypes to classical pegylated interferon-ribavirin therapy differs and no success has been achieved in some even after repeated therapy cycles. New types of so called directly acting antivirals (DAAs) are hopeful, as shown in many recent clinical studies, and triple therapy regimens involving DAA are becoming the new standard of care.Objective: To summarize knowledge about the relationship between HCV therapeutic regimens and the genetic background of the host represented by interleukin 28B (IL28B) gene polymorphisms. In the first part, the host basic mechanisms in specific and innate immunity are introduced. The IL28B genotype and its role in the course of HCV treatment are described in the second part.Methods: We searched and summarized publications on HCV therapeutic regimens and host IL28B polymorphisms.Results: Compared to classical regimens, the association between IL28B polymorphism and treatment outcome of HCV infected patients is weaker in triple therapy using first generation DAAs boceprevir and telaprevir.Conclusions: The association between IL28B polymorphism and treatment outcome is lessened with availability of new therapeutic regimens. Nevertheless, IL28B genotyping may still be useful for individualization of treatment strategies.
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Affiliation(s)
- Dalibor Novotny
- PhD, Department of Clinical Biochemistry, University Hospital Olomouc, 77520 Olomouc, Czechia
| | - Lucie Roubalova
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc 77520, Czechia
| | - Kvetoslava Aiglova
- Department of Internal Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc 77520, Czechia
| | - Jana Bednarikova
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc 77520, Czechia
| | - Margita Bartkova
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc 77520, Czechia
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Prevalence of Hepatitis C Virus Infection and Its Risk Factors among Patients Attending Rwanda Military Hospital, Rwanda. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5841272. [PMID: 28246598 PMCID: PMC5299157 DOI: 10.1155/2017/5841272] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/07/2016] [Accepted: 12/18/2016] [Indexed: 12/19/2022]
Abstract
In Rwanda, the prevalence of viral hepatitis (HCV) is poorly understood. The current study investigated the prevalence and risk factors of HCV infection in Rwanda. A total of 324 patients attending Rwanda Military Hospital were randomly selected and a questionnaire was administered to determine the risk factors. Blood was collected and screened for anti-HCV antibodies and seropositive samples were subjected to polymerase chain reaction method. Hematology abnormalities in the HCV infected patients were also investigated. Anti-HCV antibody and active HCV infection were found in 16.0% and 9.6% of total participants, respectively. Prevalence was highest (28.4%; 19/67) among participants above 55 years and least (2.4%; 3/123) among younger participants (18-35 years). There was a significant (P = 0.031) relationship between place of residence and HCV infection with residents of Southern Province having significantly higher prevalence. The hematological abnormalities observed in the HCV infected patients included leukopenia (48.4%; 15/52), neutropenia (6.5%; 2/52), and thrombocytopenia (25.8%; 8/52). The HCV infection was significantly higher in the older population (>55 years) and exposure to injection from traditional practitioners was identified as a significant (P = 0.036) risk factor of infection. Further studies to determine the factors causing the high prevalence of HCV in Rwanda are recommended.
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Spontaneous Elimination of Hepatitis C Virus Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1039:45-54. [PMID: 29164488 DOI: 10.1007/5584_2017_76] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hepatitis C virus (HCV) is the etiological agent of chronic hepatitis C and a major cause of liver cirrhosis and hepatocellular carcinoma. Only a minority of infected individuals can clear the virus spontaneously. The knowledge of the determinants of virus clearance would allow the development of effective methods preventing its further spread and optimizing treatment regimens. Viral factors associated with spontaneous virus clearance in the acute phase of infection, such as HCV genotype, virus heterogeneity, and the impact of viral proteins on the immune system have been characterized. Likewise, host genetic markers, such as the interleukin genotypes, HLA alleles, and factors affecting the T lymphocyte response appear to play an important role. Studies have revealed that natural clearance of HCV infection in the chronic phase is rare and its mechanisms are not well understood. In this review, we present the state-of-the art knowledge on the viral and host factors affecting the spontaneous elimination of HCV infection.
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Shao X, Luo Q, Cai Q, Zhang F, Zhu J, Liu Y, Zhao Z, Gao Z, Zhang X. An outbreak of HCV genotype 6a and 2a infection in South China: Confirmation of iatrogenic transmission by phylogenetic analysis of the NS5B region. Mol Med Rep 2016; 14:4285-4292. [PMID: 27633350 DOI: 10.3892/mmr.2016.5737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/02/2016] [Indexed: 11/06/2022] Open
Abstract
An outbreak of hepatitis C virus (HCV) infections, for which the risk factor was unknown, was previously identified in North Guangdong, China. In the present study, a total of 736 local residents were surveyed regarding their lifetime risk factors for HCV infection. Serum anti‑HCV antibodies and HCV RNA were examined to confirm infection. In the HCV‑positive samples, the core and nonstructural protein 5B sequences were amplified, and phylogenetic analysis was performed to determine the association between HCV subtypes and transmission routes. A total of 374 individuals were positive for anti‑HCV antibodies. Blood transfusion, blood product transfusion, people who inject drugs and intravenous injection at a local clinic were identified as independent risk factors for HCV infection. Phylogenetic analysis revealed that the two predominant subtypes of HCV, 2a and 6a, were primarily focused in four homologous clusters. Patients with a history of intravenous injection at a local clinic were more likely to be found in the four clusters, compared with patients exposed to other risk factors. The present emergency retrospective survey showed a specific epidemiological feature of HCV infection in Zijin County and found genetic homology among individuals exposed to intravenous injection at a local clinic. Further evidence is required to confirm the causal association between the outbreak of HCV infection and intravenous injection.
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Affiliation(s)
- Xiaoqiong Shao
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Qiumin Luo
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Qingxian Cai
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Fulong Zhang
- Department of Internal Medicine, Zijin County People's Hospital, Heyuan, Guangdong 517400, P.R. China
| | - Jiangyun Zhu
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Ying Liu
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Zhixin Zhao
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Zhiliang Gao
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
| | - Xiaohong Zhang
- Department of Infectious Disease, The Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
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Wang C, Shi CX, Rou K, Zhao Y, Cao X, Luo W, Liu E, Wu Z. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China's National Methadone Maintenance Treatment Program. PLoS One 2016; 11:e0147922. [PMID: 26906025 PMCID: PMC4764346 DOI: 10.1371/journal.pone.0147922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 01/11/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT) program. METHODS Data from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution. RESULTS Anti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17-8.52, p<0.0001) and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96-2.06, p<0.0001). Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001). Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012. CONCLUSIONS The current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China.
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Affiliation(s)
- Changhe Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cynthia X. Shi
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keming Rou
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaobin Cao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Luo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Enwu Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: ;
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Lee MH, Yang HI, Lu SN, Lin YJ, Jen CL, Wong KH, Chan SY, Chen LC, Wang LY, L’Italien G, Yuan Y, Chen CJ. Polymorphisms near the IFNL3 Gene Associated with HCV RNA Spontaneous Clearance and Hepatocellular Carcinoma Risk. Sci Rep 2015; 5:17030. [PMID: 26602024 PMCID: PMC4658500 DOI: 10.1038/srep17030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/22/2015] [Indexed: 12/14/2022] Open
Abstract
The aims of this study were to investigate associations between single nucleotide polymorphisms (SNPs) near the genes IFNL2, IFNL3, and IFNL4 and spontaneous clearance of hepatitis C virus (HCV) and to evaluate variants for their risk of hepatocellular carcinoma (HCC) among subjects in whom spontaneous HCV RNA clearance did not occur. In the first study, 889 untreated anti-HCV-seropositive patients without HCC symptoms were followed from 1991 to 2005. The spontaneous HCV clearance rate was found to be 33.1%. The TT variant of rs8099917 near IFNL3 was associated with increased spontaneous HCV RNA clearance, with an adjusted odds ratio (95% CI) of 2.78 (1.43-5.39), as was the newly-identified TT/TT dinucleotide variant rs368234815 near IFNL4 (adjusted odds ratio 2.68, 95% CI: 1.42-5.05). In the second study, associations between SNPs and HCC risk were examined in 483 HCC cases with detectable HCV RNA and 516 controls. In participants with HCV genotype 1, unfavorable genotypes for HCV clearance near IFNL3 were associated with increased HCC risk, the adjusted odds ratio (95% CI) for rs12979860 and rs8099917 being 1.73 (1.00-2.99) and 1.84 (1.02-3.33), respectively. Host characteristics should be considered to identify high-risk patients to prioritize the use of new antiviral agents and intensive screening.
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Affiliation(s)
- Mei-Hsuan Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hwai-I Yang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Sheng-Nan Lu
- Division of Hepato-Gastroenterology, (Department of Internal Medicine), Kaohsiung Chang Gung Memorial Hospital, KaohsiungChang Gung University School of Medicine, Kaohsiung, Taiwan
| | - Yu-Ju Lin
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Graduate Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Lan Jen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Kang-Hsuan Wong
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Soa-Yu Chan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Chun Chen
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | - Gilbert L’Italien
- Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, United States
- Yale University School of Medicine, New Haven, CT, United States
| | - Yong Yuan
- Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, United States
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei , Taiwan
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Martin-Santos R, Egmond E, Cavero M, Mariño Z, Subira S, Navines R, Forns X, Valdes M. Chronic hepatitis C, depression and gender: a state of art. ADVANCES IN DUAL DIAGNOSIS 2015. [DOI: 10.1108/add-05-2015-0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose
– The purpose of this paper is to provide a comprehensive overview of the current knowledge regarding chronic hepatitis C (CHC) infection, antiviral therapy, depression, and gender.
Design/methodology/approach
– CHC and its treatment options were reviewed examining their relationship with depression and gender.
Findings
– CHC is a high prevalent chronic infection worldwide, being similar in men and women. However, the infection shows many gender differences in terms of innate response, genetic variability (i.e. IL-28B), route of transmission (i.e. intravenous drug use), disease progression (i.e. fibrosis), lifetime period (i.e. pregnancy), and risk factors (i.e. HIV). Both the hepatitis C infection and antiviral treatment (especially when using the pro-inflammatory cytokine interferon α), are highly associated with depression, where female gender constitutes a risk factor. It seems that the new direct-acting antiviral combinations produce fewer neuropsychiatric side effects. In fact, the presence of depression at baseline is no longer a limitation for the initiation of antiviral treatment. Antidepressant drugs have been recommended as current depression and prophylactic treatment in risk subgroups. However, caution should be exercised due to the risk of drug-drug interactions with some antiviral drugs. Women should be counselled prenatal, during and after pregnancy, taking into account the clinical situation, and the available evidence of the risks and benefits of antiviral and antidepressant treatments. Multidisciplinary approach shows cost-efficacy results.
Originality/value
– The paper clarifies the complex management of CHC therapy and the importance of individualizing treatment. The results also underline the need for an integrated multidisciplinary approach.
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Hiramine S, Sugiyama M, Furusyo N, Uto H, Ido A, Tsubouchi H, Watanabe H, Ueno Y, Korenaga M, Murata K, Masaki N, Hayashi J, Thomas DL, Mizokami M. A thymine-adenine dinucleotide repeat polymorphism near IL28B is associated with spontaneous clearance of hepatitis C virus. J Gastroenterol 2015; 50:1069-77. [PMID: 25735432 PMCID: PMC4651429 DOI: 10.1007/s00535-015-1056-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 02/11/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Genome-wide association studies have revealed several single-nucleotide polymorphisms around interleukin 28B (IL28B) that are strongly associated with hepatitis C virus (HCV) clearance. However, their predictive value is not perfect, which suggests that other genetic factors may also be involved in HCV clearance. We previously reported a wide variation in the length of a thymine-adenine (TA) dinucleotide repeat in the promoter region of IL28B and that the transcriptional activity of the promoter increased gradually in a TA repeat length-dependent manner. METHODS We determined the length of the TA repeats of 1,060 Japanese and 201 African-American samples to investigate the relation to spontaneous HCV clearance. RESULTS The distribution of the TA repeats greatly differed between the two ethnicities. The variation ranged from 10 to 18 repeats, and the most frequent allele, 12, accounted for over 80% for Japanese. The African-American data showed a gently sloping distribution, and the allele with six repeats was detected only in the African-American sample. The TA repeats 11 or greater were correlated with spontaneous clearance. Multiple logistic regression analysis extracted the genotype of the TA repeats as an independent factor in both the Japanese [p = 0.0004, odds ratio (OR) = 13.02 95% confidence interval (CI) = 2.59-237.0] and African-American (p = 0.027, OR = 3.70 95% CI = 1.16-11.8) populations. CONCLUSIONS A long TA repeat in the promoter region of IL28B was associated with spontaneous HCV clearance. Although its efficacy may be limited in Japanese population because of its allele distribution, this novel genetic factor will be useful for predicting HCV clearance especially for the African Americans.
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Affiliation(s)
- Satoshi Hiramine
- Department of Hepatic Diseases, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohonodi, Ichikawa, 272-8516, Chiba, Japan
- General Internal Medicine Department, Kyushu University Hospital, Fukuoka, 812-8582, Japan
| | - Masaya Sugiyama
- Department of Hepatic Diseases, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohonodi, Ichikawa, 272-8516, Chiba, Japan
| | - Norihiro Furusyo
- General Internal Medicine Department, Kyushu University Hospital, Fukuoka, 812-8582, Japan
| | - Hirofumi Uto
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-8544, Japan
| | - Akio Ido
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-8544, Japan
| | - Hirohito Tsubouchi
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-8544, Japan
| | - Hisayoshi Watanabe
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, 990-9585, Japan
| | - Yoshiyuki Ueno
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, 990-9585, Japan
| | - Masaaki Korenaga
- Department of Hepatic Diseases, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohonodi, Ichikawa, 272-8516, Chiba, Japan
| | - Kazumoto Murata
- Department of Hepatic Diseases, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohonodi, Ichikawa, 272-8516, Chiba, Japan
| | - Naohiko Masaki
- Department of Hepatic Diseases, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohonodi, Ichikawa, 272-8516, Chiba, Japan
| | - Jun Hayashi
- General Internal Medicine Department, Kyushu University Hospital, Fukuoka, 812-8582, Japan
| | - David L Thomas
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Masashi Mizokami
- Department of Hepatic Diseases, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohonodi, Ichikawa, 272-8516, Chiba, Japan.
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Abstract
Liver-related biomarkers have been developed and validated mainly in patients with chronic hepatitis C for the prediction of liver fibrosis or cirrhosis, which is a final pathway of chronic liver injury. They are noninvasive, traceable, and easy-to-use. Biomarkers provide implications related to screening, diagnosis, treatment, and prognosis of chronic hepatitis. For the improvement of performance and coverage, biomarker panels, imaging biomarkers, and even genetic biomarkers have been developed. With the advancement of genomics and proteomics, earlier and more precise prediction is expected in the near future. In this review, multiple biomarker panels for the estimation of the degree of fibrosis in chronic hepatitis C, biomarkers for the screening and diagnosis of hepatitis C, biomarkers for the treatment of hepatitis C, biomarkers for the prediction of complications related to the chronic hepatitis C, and future perspectives will be summarized.
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Affiliation(s)
- Seung Ha Park
- Department of Internal Medicine, Inje University College of Medicine, Busan, South Korea
| | - Chang Seok Bang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
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Moqueet N, Infante-Rivard C, Platt RW, Young J, Cooper C, Hull M, Walmsley S, Klein MB. Favourable IFNL3 genotypes are associated with spontaneous clearance and are differentially distributed in Aboriginals in Canadian HIV-hepatitis C co-infected individuals. Int J Mol Sci 2015; 16:6496-512. [PMID: 25803108 PMCID: PMC4394544 DOI: 10.3390/ijms16036496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/13/2015] [Accepted: 03/13/2015] [Indexed: 12/13/2022] Open
Abstract
Canadian Aboriginals are reported to clear Hepatitis C (HCV) more frequently. We tested the association of spontaneous clearance and three single nucleotide polymorphisms (SNPs) near the Interferon-lambda 3 (IFNL3) gene (rs12979860, rs8099917, functional variant rs8103142) and compared the SNP frequencies between HIV-HCV co-infected whites and Aboriginals from the Canadian Co-infection Cohort. HCV treatment-naïve individuals with at least two HCV RNA tests were included (n = 538). A spontaneous clearance case was defined as someone with two consecutive HCV RNA-negative tests, at least six months apart. Data were analyzed using Cox proportional hazards adjusted for sex and ethnicity. Advantageous variants and haplotypes were more common in Aboriginals than Caucasians: 57% vs. 46% had the rs12979860 CC genotype, respectively; 58% vs. 48%, rs8103142 TT; 74% vs. 67%, the rs12979860 C allele; and 67% vs. 64% the TCT haplotype with three favourable alleles. The adjusted Hazard Ratios (95% CI) for spontaneous clearance were: rs12979860: 3.80 (2.20, 6.54); rs8099917: 5.14 (2.46, 10.72); and rs8103142: 4.36 (2.49, 7.62). Even after adjusting for rs12979860, Aboriginals and females cleared HCV more often, HR (95% CI) = 1.53 (0.89, 2.61) and 1.42 (0.79, 2.53), respectively. Our results suggest that favourable IFNL3 genotypes are more common among Aboriginals than Caucasians, and may partly explain the higher HCV clearance rates seen among Aboriginals.
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Affiliation(s)
- Nasheed Moqueet
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada.
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada.
| | - Robert W Platt
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada.
| | - Jim Young
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel 4031, Switzerland.
- Department of Medicine, Division of Infectious Diseases/Chronic Viral Illness Service, Royal Victoria Hospital, McGill University Health Centre, 3650 Saint-Urbain Street, Montreal, QC H2X 2P4, Canada.
| | - Curtis Cooper
- The Ottawa Hospital-Research Institute, Ottawa, ON K1Y 4E9, Canada.
| | - Mark Hull
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.
| | - Sharon Walmsley
- Toronto General Research Institute, University Health Network, University of Toronto, Toronto, ON M5G 2M9, Canada.
| | - Marina B Klein
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada.
- Department of Medicine, Division of Infectious Diseases/Chronic Viral Illness Service, Royal Victoria Hospital, McGill University Health Centre, 3650 Saint-Urbain Street, Montreal, QC H2X 2P4, Canada.
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30
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Bertol BC, Moreira S, Garcia RFL, Ferreira LE, Debortoli G, Pinho MDSL, Amendola-Pires M, Maciel AMDA, Brandço-Mello CE, de França PHC. IL28B gene polymorphisms in mono- and HIV-coinfected chronic hepatitis C patients. Front Microbiol 2015; 6:153. [PMID: 25788894 PMCID: PMC4349181 DOI: 10.3389/fmicb.2015.00153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 02/10/2015] [Indexed: 12/19/2022] Open
Abstract
Introduction: Single-nucleotide polymorphisms (SNPs) associated with hepatitis C virus (HCV) clearance were identified near the IL28B gene. Coinfection by the human immunodeficiency virus (HIV) influences the course of HCV contributing to liver damage. Nevertheless, little is known about the relationship between these SNPs and HCV/HIV coinfection. Our aim was to estimate the frequencies of the allelic and genotypic variants of the IL28B polymorphisms rs12979860 (C/T) and rs8099917 (T/G) and their possible association with the establishment of HCV infection. Methodology: A total of 199 non-infected controls and 230 patients with chronic hepatitis C, including 53 coinfected with HIV, participated in the study. Genotyping consisted of polymerase chain reaction and subsequent analysis of the restriction patterns resulting from exposure to endonucleases. Results: Among the controls with established results, 47.4% (90/190) exhibited the rs12979860 CC genotype, 43.7 CT, and 8.9% TT, whereas 29.1% (66/227), 51.5%, and 19.4% of the patients exhibited the CC, CT, and TT genotypes, respectively. With respect to rs8099917, 66.8% (133/199) of the controls exhibited the TT genotype, 31.2% TG, and 2.0% GG, whereas 56.1% (129/230), 40.9%, and 3.0% of the patients exhibited the TT, TG, and GG genotypes, respectively. Conclusion: The frequencies of the rs12979860 C allele and CC genotype and of the rs8099917 T allele and TT genotype were significantly higher among controls compared with patients, thus confirming the suggested protective effect against HCV infection. No significant difference was observed in the genotype and allelic distributions between the mono- and coinfected patients.
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Affiliation(s)
- Bruna C Bertol
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil
| | - Simone Moreira
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil
| | - Raquel F L Garcia
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil ; Hospital Municipal São José, Joinville Brazil
| | - Leslie E Ferreira
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil
| | - Guilherme Debortoli
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil
| | - Mauro de Souza Leite Pinho
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil ; Hospital Municipal São José, Joinville Brazil
| | - Marcia Amendola-Pires
- Hospital Universitário Gaffrée Guinle - Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro Brazil
| | | | - Carlos E Brandço-Mello
- Hospital Universitário Gaffrée Guinle - Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro Brazil
| | - Paulo H C de França
- Laboratory of Molecular Biology, Department of Medicine, Universidade da Região de Joinville Joinville, Brazil
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You H, Liu S, Xie Y, Cong R, Sun Y, Ren J, Wei K, Jin X, Shi Y, Zhang H, Li J, Wei L, Zhuang H, Cheng M, Jia J. Novel host genetic variations associated with spontaneous clearance of a single-source outbreak of HCV1b infections. BMJ Open Gastroenterol 2015; 1:e000010. [PMID: 26462265 PMCID: PMC4533326 DOI: 10.1136/bmjgast-2014-000010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/24/2014] [Accepted: 08/29/2014] [Indexed: 12/13/2022] Open
Abstract
Background and aims A total of 105 patients were identified as accidentally infected with hepatitis C virus genotype 1b (HCV1b) through blood transfusion from a single blood donor. This group provides a unique patient population to study host factors involved in the spontaneous clearance of HCV and disease progression. Methods Clinical markers, HCV RNA and eight single nucleotide polymorphisms (SNPs) of interleukin-28B (IL-28B) were detected. Exome capture and sequencing were analysed for association with HCV clearance. Results Among the 85 patients with the positive HCV antibody, 27 cases (31.8%) were HCV RNA negative over a period of 9–12 years. Of the 58 patients with positive HCV RNA, 22.4% developed chronic hepatitis, and 5.2% developed cirrhosis. Age was found to be associated with HCV1b clearance. IL-28 rs10853728 CC showed the trend. By exon sequencing, 39 SNPs were found to be significantly different in spontaneous clearance patients (p<0.001). Two SNPs in the tenascin receptor (TNR), five in the transmembrane protease serine 11A (TMPRSS11A), and one in the serine peptidase inhibitor kunitz type 2 (SPINT2) showed the closest associations (p<10−5). Conclusions Host genetic analyses on the unique, single source HCV1b-infected patient population has suggested that age and mutations in TNR, TMPRSS11A and SPINT2 genes may be factors associated with HCV clearance.
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Affiliation(s)
- Hong You
- Liver Research Center , Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing Friendship Hospital, Capital Medical University , Beijing , China
| | - Sandu Liu
- Department of Infectious Diseases , Qiannan People's Hospital , Guizhou , China
| | - Yong Xie
- Department of Infectious Diseases , Pingtang People's Hospital , Guizhou , China
| | - Rui Cong
- Liver Research Center , Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing Friendship Hospital, Capital Medical University , Beijing , China
| | - Yameng Sun
- Liver Research Center , Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing Friendship Hospital, Capital Medical University , Beijing , China
| | - Jingjing Ren
- Beijing Genomic Institute , Shenzhen, Guangdong , China
| | - Kangfei Wei
- Beijing Genomic Institute , Shenzhen, Guangdong , China
| | - Xin Jin
- Beijing Genomic Institute , Shenzhen, Guangdong , China
| | - Yujian Shi
- Beijing Genomic Institute , Shenzhen, Guangdong , China
| | - Haiying Zhang
- Hepatology Institute, Peking University People's Hospital , Beijing , China
| | - Jie Li
- Department of Microbiology , Peking University Health Science Center , Beijing , China
| | - Lai Wei
- Hepatology Institute, Peking University People's Hospital , Beijing , China
| | - Hui Zhuang
- Department of Microbiology , Peking University Health Science Center , Beijing , China
| | - Mingliang Cheng
- Department of Infectious Diseases , Guiyang Medical College , Guizhou , China
| | - Jidong Jia
- Liver Research Center , Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing Friendship Hospital, Capital Medical University , Beijing , China
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32
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Griffiths SJ, Dunnigan CM, Russell CD, Haas JG. The Role of Interferon-λ Locus Polymorphisms in Hepatitis C and Other Infectious Diseases. J Innate Immun 2015; 7:231-42. [PMID: 25634147 PMCID: PMC6738896 DOI: 10.1159/000369902] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 11/15/2014] [Indexed: 12/19/2022] Open
Abstract
Since its discovery in 2003, the type III interferon-λ (IFN-λ) family has been found to contribute significantly to the host response to infection. Whilst IFN-λ shares many features with type I IFN induction and signalling pathways, the tissue-specific restricted expression of its receptor, IL28RA, makes IFN-λ a major mediator of host innate immunity in tissues and organs with a high epithelial cell content. Host susceptibility and responses to infection are known to be heterogeneous, and the identification of common genetic variants linked to disease outcome by genome-wide association studies (GWAS) has underscored the significance of host polymorphisms in responses to infection. Several such GWAS have highlighted the IFN-λ locus on chromosome 19q13 as an area of genetic variation significantly associated with hepatitis C virus (HCV) infection, and the rs12979860 genotype can be used in clinical practice as a biomarker for predicting a successful response to treatment with pegylated IFN and ribavarin. Here, we discuss IFN-λ genetic polymorphisms and their role in HCV and other infectious diseases as well as their potential impact on clinical diagnostics, patient stratification and therapy. Finally, the broader role of IFN-λ in the immunopathogenesis of non-infectious inflammatory diseases is considered.
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Affiliation(s)
- Samantha J Griffiths
- Division of Infection and Pathway Medicine, University of Edinburgh Medical School, Edinburgh, UK
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Wang J, Jiang D, Rao H, Yang R, Wang Y, Wei L. Association of interferon-γ-induced protein-10 serum levels with virological responses to PEG-interferon-based therapy in hepatitis C virus genotype 1 or 2 chronically infected Chinese patients. Scand J Gastroenterol 2014; 49:1349-58. [PMID: 25263691 DOI: 10.3109/00365521.2014.962609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Interferon (IFN)-γ-induced protein-10 (IP-10) serum level has been shown be associated with viral response in chronic hepatitis C (CHC) patients. However, little is known in Chinese population. We determined IP-10 serum levels in Chinese CHC patients undergoing PEG-IFN-based therapy. Predictive role of IP-10 level for virological responses was accessed. MATERIAL AND METHODS IP-10 serum levels were determined in 165 hepatitis C virus (HCV) genotype 1 and 33 genotype 2 patients. Multivariate analysis was performed to screen independent factors for sustained virological response (SVR) prediction. Predictive value of IP-10 level in combination with interleukin 28B (IL28B) genotype or rapid virological response was further investigated. RESULTS Our study showed that pretreatment IP-10 level was significantly higher in HCV genotype 1 patients. IP-10 levels were independently predictive for SVR with cut-off values of 250.60 pg/ml at baseline or 407.40 pg/ml at week 4. Positive predictive value (PPV) for SVR of low IP-10 level at baseline and IL28B CC genotype was 96.15% and negative predictive value (NPV) was 50.00%. PPV for SVR of low IP-10 level at week 4 and rapid viral response (RVR) was 95.24% and NPV was 50.00%. CONCLUSION Together our study indicated that higher IP-10 serum levels were associated with HCV genotype 1 CHC Chinese patients. IP-10 levels at baseline and week 4 were both predictive of SVR and improved predictive performances of IL28B genotype and RVR for SVR.
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Affiliation(s)
- Jianghua Wang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases , No.11, Xizhimen South Street, Beijing 100044 , China
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Song Q, Zhao C, Ou S, Meng Z, Kang P, Fan L, Qi F, Ma Y. Co-expression analysis of differentially expressed genes in hepatitis C virus-induced hepatocellular carcinoma. Mol Med Rep 2014; 11:21-8. [PMID: 25339452 PMCID: PMC4237098 DOI: 10.3892/mmr.2014.2695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 03/21/2014] [Indexed: 12/11/2022] Open
Abstract
The aim of the current study was to investigate the molecular mechanisms underlying hepatitis C virus (HCV)-induced hepatocellular carcinoma (HCC) using the expression profiles of HCV-infected Huh7 cells at different time points. The differentially expressed genes (DEGs) were identified with the Samr package in R software once the data were normalized. Functional and pathway enrichment analysis of the identified DEGs was also performed. Subsequently, MCODE in Cytoscape software was applied to conduct module analysis of the constructed co-expression networks. A total of 1,100 DEGs were identified between the HCV-infected and control samples at 12, 18, 24 and 48 h post-infection. DEGs at 24 and 48 h were involved in the same signaling pathways and biological processes, including sterol biosynthetic processes and tRNA amino-acylation. There were 22 time series genes which were clustered into 3 expression patterns, and the demarcation point of the 2 expression patterns that 401 overlapping DEGs at 24 and 48 h clustered into was 24 h post-infection. tRNA synthesis-related biological processes emerged at 24 and 48 h. Replication and assembly of HCV in HCV-infected Huh7 cells occurred mainly at 24 h post-infection. In view of this, the screened time series genes have the potential to become candidate target molecules for monitoring, diagnosing and treating HCV-induced HCC.
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Affiliation(s)
- Qingfeng Song
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Chang Zhao
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Shengqiu Ou
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhibin Meng
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Ping Kang
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Liwei Fan
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Feng Qi
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yilong Ma
- Department of Interventional Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Liu Y, Shen T, Zhang C, Long L, Duan Z, Lu F. HIV co-infection accelerates decay of humoral responses in spontaneous resolvers of HCV infection. J Viral Hepat 2014; 21:690-5. [PMID: 24861885 PMCID: PMC4263235 DOI: 10.1111/jvh.12238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 12/17/2013] [Indexed: 01/07/2023]
Abstract
Acute hepatitis C virus (HCV) infection is primarily followed by chronic infection, while spontaneous recovery of HCV infection (SR-HCV) occurs in a minority of those infected. Identification of SR-HCV clinically depends on two combined indicators, persistently undetectable peripheral HCV RNA and positivity for anti-HCV. However, the characteristics of dynamic variation in anti-HCV antibodies in SR-HCV, especially in those patients co-infected with HIV, are still undefined. In this study, a cohort of patients infected with HCV through commercial blood collection practices was studied. We found that the annual decreasing rate of anti-HCV presented a gradually accelerated process in HCV resolvers. However, the variation in the decline of anti-HCV presented a slowly accelerated process within the early decrease stage and a gradually decelerated process within the latter decrease stage. In addition, we deduced that it expended approximately 16 years from natural HCV recovery to undetectable peripheral anti-HCV in HCV resolvers co-infected with HIV, while this time was estimated to be 20 years in SR-HCV without HIV co-infection. Our data indicated that the decay of anti-HCV was accelerated by HIV-related impairment of immune function. The prevalence of HCV infection may be severely underestimated in this large-scale retrospective epidemiologic investigation in an HIV-infected population.
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Affiliation(s)
- Y Liu
- Department of Microbiology, Peking University Health Science CenterBeijing, China,Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou UniversityHenan, China
| | - T Shen
- Department of Microbiology, Peking University Health Science CenterBeijing, China,Center of Infectious Diseases, Peking UniversityBeijing, China
| | - C Zhang
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijing, China
| | - L Long
- Department of Microbiology, Peking University Health Science CenterBeijing, China
| | - Z Duan
- Department of Microbiology, Peking University Health Science CenterBeijing, China
| | - F Lu
- Department of Microbiology, Peking University Health Science CenterBeijing, China,Center of Infectious Diseases, Peking UniversityBeijing, China
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Abstract
Interferon has been the backbone of HCV treatment since this agent was first introduced nearly two decades ago. Interferon acts to eradicate HCV via two mechanisms: by directly inhibiting HCV replication via an indirect anti-viral mechanism and by modulating an immune response against hepatocytes infected with HCV. The current treatment of chronic HCV genotype 1 is the combination of peginterferon, ribavirin and a single direct acting anti-viral agent (DAA). Within the next 1-2 years multiple DAA combinations will eradicate and cure HCV at high rates without interferon. The role interferon will play in the next era of HCV treatment will depend upon balancing cost, efficacy and the development of an interferon with a more favorable adverse event profile.
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Factors associated with spontaneous clearance of hepatitis C virus in Chinese population. BIOMED RESEARCH INTERNATIONAL 2014; 2014:527030. [PMID: 25133165 PMCID: PMC4123573 DOI: 10.1155/2014/527030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 06/20/2014] [Accepted: 06/20/2014] [Indexed: 12/27/2022]
Abstract
Hepatitis C virus (HCV) infections spontaneously clear in approximately 15-45% of infected individuals. Factors which influence spontaneous HCV clearance remain to be identified. The purpose of the present study was to identify variables associated with spontaneous HCV clearance in a referred population of Chinese patients. The prevalence of host, viral, and environmental factors known to influence the outcome of HCV infections was compared in 92 HCV spontaneous clearance subjects and 318 HCV persistent infection subjects. Univariate and multivariate analyses were performed to identify those factors associated with spontaneous HCV clearance. In univariate analysis, female gender, a history of icteric hepatitis, serologic evidence of concurrent HBV infection, and rs12979860 CC genotype were positively associated with spontaneous HCV clearance, while alcohol consumption was negatively associated with clearance. In multivariate analysis, female gender, a history of icteric hepatitis, concurrent HBV infection, and rs12979860 CC genotype remained independent variables associated with spontaneous HCV clearance. Spontaneous HCV clearance is more likely to occur in females, subjects with a history of icteric hepatitis, HBV coinfections, and those with the rs12979860 CC genotype.
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KASL clinical practice guidelines: management of hepatitis C. Clin Mol Hepatol 2014; 20:89-136. [PMID: 25032178 PMCID: PMC4099340 DOI: 10.3350/cmh.2014.20.2.89] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 05/20/2014] [Indexed: 12/16/2022] Open
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Wu RR, Liu FQ, Zhu SS, Han J. Association of Hepatitis C Virus Infection and Interleukin-28B Gene Polymorphism in Chinese Children. Pak J Med Sci 2014; 30:519-24. [PMID: 24948971 PMCID: PMC4048498 DOI: 10.12669/pjms.303.4267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 02/10/2014] [Accepted: 02/12/2014] [Indexed: 12/17/2022] Open
Abstract
Objective: To preliminarily explore the association of rs12979860 and rs8099917 SNPs with chronic HCV infection in Chinese Han children. Methods: Chronic HCV infection patients (n=277; 1-17 years old, 4.5 years old in average) and healthy subjects (n=150, children; 2-17 years old, 5.2 years old in average) were recruited and tested by PCR combining direct sequencing. The differences between the rs12979860 and rs8099917 genotypes in patients and healthy subjects were compared. Results: The genetic variations at rs12979860 and rs8099917 in chronic hepatitis C (CHC) children and healthy subjects did not differ significantly. The frequency of spontaneous clearance in CHC children was higher (47%), which is related to the genetic variations. The histological changes of patients were more significant compared to their clinical and biochemical indices, but they did not correlate with the genetic mutations at rs12979860 and rs8099917 significantly. Conclusion: The rs12979860 and rs8099917 SNPs are independent factors predicting the spontaneous clearance of Chinese CHC children patients. The correlation between diseases outcomes are in need of further study.
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Affiliation(s)
- Rong-Rong Wu
- Rong-Rong Wu, Department of Pharmacy, Beijing 302 Hospital, Beijing China
| | - Feng-Qun Liu
- Feng-Qun Liu, Department of Pharmacy, Beijing 302 Hospital, Beijing China
| | - Shi-Shu Zhu
- Shi-Shu Zhu, Department of Pediatric Hepatology, Beijing 302 Hospital, Beijing China
| | - Jin Han
- Jin Han, Department of Pharmacy, Beijing 302 Hospital, Beijing China
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Rao H, Wei L, Lopez-Talavera JC, Shang J, Chen H, Li J, Xie Q, Gao Z, Wang L, Wei J, Jiang J, Sun Y, Yang R, Li H, Zhang H, Gong Z, Zhang L, Zhao L, Dou X, Niu J, You H, Chen Z, Ning Q, Gong G, Wu S, Ji W, Mao Q, Tang H, Li S, Wei S, Sun J, Jiang J, Lu L, Jia J, Zhuang H. Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection. J Gastroenterol Hepatol 2014; 29:545-53. [PMID: 24090188 PMCID: PMC4272577 DOI: 10.1111/jgh.12398] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Chronic hepatitis C virus (HCV) infection is relatively frequent in China. This study investigated the clinical, demographic, and viral and host genetic characteristics that may influence disease manifestations and clinical management. METHODS In this cross-sectional observational study, treatment-naïve Han ethnic adults with recently confirmed chronic HCV infection were enrolled at 28 hospitals across China. HCV genotype and host interleukin 28B (IL28B) genotypes were determined and compared with patient demographic parameters and medical status. RESULTS Among the 997 HCV-positive patients analyzed, 56.8% were infected with HCV genotype 1b, followed in prevalence by genotypes 2, 3, and 6, with substantial regional variation. Overall, 84.1% of patients were IL28B genotype CC (rs12979860), with little regional variation. Cirrhosis was reported in 10.1% of patients and was significantly associated with hepatitis B virus coinfection, low HCV viral load, low serum alanine aminotransferase, high serum aspartate aminotransferase, diabetes, and high pickled food consumption. Medical procedures were common transmission risk factors; however, lifestyle-associated risk factors, including intravenous drug abuse and tattoos or piercings, were more common in patients with HCV genotype 3 or 6. CONCLUSIONS Most HCV-infected Han Chinese patients were IL28B genotype CC (rs12979860). HCV genotypes varied by geographic region, and disease characteristics differed according to HCV genotype. Relatively frequent detection of advanced liver disease may reflect limitations on access to antiviral therapy, and suggests that greater awareness of factors that influence HCV-associated disease may help avoid clinical complications and improve patient outcomes.
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Affiliation(s)
- Huiying Rao
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver DiseaseBeijing, China
| | - Lai Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver DiseaseBeijing, China
| | | | - Jia Shang
- Henan Provincial People's HospitalZhengzhou, China
| | - Hong Chen
- First Hospital of Lanzhou UniversityLanzhou, China
| | - Jun Li
- First Affiliated Hospital with Nanjing Medical UniversityNanjing, China
| | - Qing Xie
- Shanghai Ruijin HospitalShanghai, China
| | - Zhiliang Gao
- Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, China
| | - Lei Wang
- Second Hospital of Shandong UniversityJinan, China
| | - Jia Wei
- First Affiliated Hospital of Kunming Medical CollegeKunming, China
| | - Jianning Jiang
- First Affiliated Hospital of Guangxi Medical UniversityNanning, China
| | - Yongtao Sun
- Fourth Military Medical University, Tangdu HospitalXi'an, China
| | - Ruifeng Yang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver DiseaseBeijing, China
| | - Hong Li
- Bristol-Myers SquibbWallingford, Connecticut, USA
| | - Haiying Zhang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver DiseaseBeijing, China
| | - Zuojiong Gong
- People's Hospital of Hubei Wuhan UniversityWuhan, China
| | - Lunli Zhang
- First Affiliated Hospital of Nanchang UniversityNanchang, China
| | - Longfeng Zhao
- First Affiliated Hospital of Shanxi Medical UniversityTaiyuan, China
| | - Xiaoguang Dou
- Shengjing Hospital of China Medical UniversityShenyang, China
| | - Junqi Niu
- First Hospital of Jilin UniversityChangchun, China
| | - Hong You
- Beijing Friendship Hospital, Capital Medical UniversityBeijing, China
| | - Zhi Chen
- First Affiliated Hospital of Medical College ZheJiang UniversityHangzhou, China
| | - Qin Ning
- Affiliated Tongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhan, China
| | - Guozhong Gong
- Second Xiangya Hospital of Central South UniversityChangsha, China
| | - Shuhuan Wu
- First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Wei Ji
- Ningxia People's HospitalYinchuan, China
| | - Qing Mao
- Southwest HospitalChongqing, China
| | | | - Shuchen Li
- Second Affiliated Hospital of Harbin Medical UniversityHarbin, China
| | - Shaofeng Wei
- First Affiliated Hospital of Anhui Medical UniversityHefei, China
| | - Jian Sun
- Nanfang Hospital, Southern Medical UniversityGuangzhou, China
| | - Jiaji Jiang
- First Affiliated Hospital of Fujian Medical UniversityFuzhou, China
| | - Lungen Lu
- Shanghai First People's Hospital, Shanghai Jiao Tong University School of MedicineShanghai, China
| | - Jidong Jia
- Beijing Friendship Hospital, Capital Medical UniversityBeijing, China
| | - Hui Zhuang
- Peking University Health Science CenterBeijing, China
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Abstract
The acute phase of hepatitis C (HCV) infection is typically defined as the initial 6 months following exposure to the virus; however, in some individuals, the acute phase of the infection can last much longer (Orland et al. Hepatology 33:321-27, 2001). Although some patients have symptoms of acute hepatitis, most infected individuals are entirely asymptomatic. As a result, many patients are unaware of the infection until it progresses to chronic infection, and may not develop symptoms until decades later with the onset of decompensated cirrhosis or hepatocellular carcinoma (HCC). A substantial proportion (20-40%) of infected patients clear the virus during the acute phase. Interferon-based treatment is also much more likely to be successful in the acute phase of infection but is relatively poorly tolerated. Therefore, recognition of acute HCV infection is critical to prioritize those patients who do not spontaneously clear the infection for immediate therapy. However, the promise of highly effective well-tolerated all-oral therapies in development may alter the management approach. This review will focus on the epidemiology, natural history, diagnosis, and treatment of acute HCV infection.
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Affiliation(s)
- Suraj A Sharma
- Toronto Center for Liver Disease, Sandra Rotman Centre for Global Health, University Health Network, University of Toronto, 6B-Fell Pavilion, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
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Yu ML, Dai CY, Huang CF, Lee JJ, Yeh ML, Yeh SM, Kuo HT, Huang JF, Chang JM, Chen HC, Juo SHH, Hwang SJ, Chuang WL. High hepatitis B virus surface antigen levels and favorable interleukin 28B genotype predict spontaneous hepatitis C virus clearance in uremic patients. J Hepatol 2014; 60:253-9. [PMID: 24096049 DOI: 10.1016/j.jhep.2013.09.023] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 09/19/2013] [Accepted: 09/23/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Host and viral factors interplay in the spontaneous clearance of hepatitis C virus (HCV) infection. We aimed to explore the roles of IL28B genotypes and hepatitis B virus (HBV) infections in spontaneous HCV seroclearance. METHODS IL28B rs8099917 genotypes, HCV and HBV markers were determined in 290 patients who were seropositive for HCV antibodies from 1681 total uremic patients on maintenance hemodialysis. RESULTS Persistent HCV viremia was observed in 74.6% (214/287) of patients. Logistic regression revealed that the strongest factors associated with spontaneous HCV seroclearance were carriage of rs8099917 TT-type (odds ratio/95% confidence intervals [OR/CI]: 6.22/1.41-27.35, p=0.016), followed by concurrent hepatitis B surface antigen (HBsAg) seropositivity (OR/CI: 2.37/1.06-5.26, p=0.035). The clearance rate was highest among patients with both positive HBsAg/rs8099917 TT-type (44.8%, OR/CI: 20.88/3.5-402.5), followed by positive HBsAg/rs8099917 non-TT-type (28.6%, OR/CI: 8.86/1.8-160.8), and negative HBsAg/rs8099917 TT-type (26.7%, OR/CI: 12.75/1.0-319.4), compared to 4% of negative HBsAg/rs8099917 non-TT-type (trend p=0.0002). HBsAg levels, but not HBV DNA levels, were significantly associated with spontaneous HCV seroclearance. Spontaneous HCV seroclearance rate was 58.3% in patients with HBsAg>200IU/ml/rs8099917 TT-type (OR/CI: 42.54/5.7-908.4), 28.0% in patients with HBsAg<200IU/ml/rs8099917 TT-type or HBsAg>200IU/ml/rs8099917 non-TT-type (OR/CI: 11.12/2.3-201.0), compared to only 3.3% in those with HBsAg<200IU/ml/rs8099917 non-TT-type (trend p=0.0004). Five of 214 (2.3%) HCV viremic patients at enrollment had spontaneous HCV seroclearance during one-year follow-up, which was associated with baseline HCV RNA and HBsAg levels. CONCLUSIONS High HBsAg levels and favorable IL28B genotype were additively associated with spontaneous HCV seroclearance in uremic patients.
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Affiliation(s)
- Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-Jung Lee
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Meng Yeh
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsing-Tao Kuo
- Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Senior Citizen Service Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Faculty of Renal Care, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Hung-Chun Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Faculty of Renal Care, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Suh-Hang Hank Juo
- Department of Medical Genetics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Faculty of Renal Care, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Liu Y, Ma H, Chen S, Wang J, Liu G, Xu M, Ke L, He M. Interleukin-28B genetic variations and spontaneous clearance of hepatitis C antibody-positive blood donors in China. Transfusion 2013; 53:2498-504. [PMID: 23782163 DOI: 10.1111/trf.12305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/07/2013] [Accepted: 05/13/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Single-nucleotide polymorphisms (SNPs) near the interleukin (IL)28B gene have been shown to be associated with spontaneous clearance of hepatitis C virus (HCV) infection in western populations. Anti-HCV-reactive and HCV RNA-negative samples were often found in Chinese blood donors. This study was to determine whether the IL28B gene variant is also associated with the natural outcome of HCV infection in Chinese blood donors. STUDY DESIGN AND METHODS A total of 111 anti-HCV-negative blood donors and 100 anti-HCV-reactive subjects were enrolled in this study. HCV-infected blood donors were classified into spontaneous clearance group and chronic infection group through HCV RNA detection. IL28B genetic variations (rs8099917 and rs12979860) were genotyped by polymerase chain reaction and direct sequencing. RESULTS A total of 24 (24.0%) donors spontaneously cleared HCV. The rs12979860 C allele frequency was 90.3% and the rs8099917 T allele frequency was 96.7% in our study. The rs12979860 CC genotype was strongly associated with spontaneous HCV clearance. Female blood donors had a higher rate of spontaneous HCV clearance than male donors (15/42 [35.7%] vs. 9/58 [15.5%], p = 0.02). CONCLUSIONS The rs12979860 CC variant upstream of IL28B gene is associated with spontaneous clearance of HCV in Chinese blood donors and female donors are more likely to clear HCV infection than male donors.
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Affiliation(s)
- Yu Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China; Peking Union Medical College, Chengdu, China; Luoyang Blood Center, Luoyang, Henan, China
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Taliani G, Spaziante M, Biliotti E, Borro M, Palazzo D, Grieco S, Franchi C, Iaiani G, Furlan C, Gallinaro V, Simmaco M. IL28B gene polymorphisms and US liver fatty changes in patients who spontaneously cleared hepatitis C virus infection. PLoS One 2013; 8:e67301. [PMID: 23936294 PMCID: PMC3731327 DOI: 10.1371/journal.pone.0067301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/16/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recent clinical studies have shown that the presence of CC genotype in the rs12979860 region of IL28B gene is associated with an increase in the probability of spontaneous clearance of hepatitis C virus (HCV). Moreover, IL28B polymorphism seems to influence the probability of developing liver steatosis in chronic HCV patients. AIMS The aims of our clinical study were 1) to verify the distribution of IL28B genotypes (CC, CT or TT) among subjects with spontaneous clearance of HCV infection and 2) to examine the correlation between IL28B polymorphism and hepatic steatosis among these subjects. METHODS AND PATIENTS We enrolled 41 subjects with spontaneous resolution of HCV infection (detectable serum anti-HCV but undetectable HCV-RNA) and 134 healthy controls from the same geographical area. The IL28B single-nucleotide polymorphism (SNP) rs12979860 was genotyped by using a Pyrosequencing™ technique. The presence of steatosis was assessed by liver biopsy or ultrasound examination in the 41 study subjects. RESULTS CC, CT and TT-genotypes of the SNP rs1979860 were found in 66%, 24% and 10% of the subjects who spontaneously cleared HCV and in 31%, 54% and 15% of controls, respectively (p = 0.0003). Among the study subjects, females with CC-genotype were significantly more represented (p = 0.02). Hepatic steatosis did not correlate with IL28B genotype (p = 0,14) but only with a high body mass index (BMI) value (p = 0.03). CONCLUSIONS Female subjects carrying IL28B CC-genotype are significantly more represented among Italian patients who spontaneously cleared HCV infection. In addition, among these subjects, the presence of liver steatosis does not correlate with IL28B genotype but is solely related to the occurrence of high BMI. Thus, the association between IL28B polymorphism and steatosis in chronic HCV patients requires the presence of active HCV replication to occur, while in subjects who have cleared the infection, the mechanism(s) inducing liver steatosis are independent from IL28B profile.
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Affiliation(s)
- Gloria Taliani
- Clinica Malattie Infettive e Tropicali, Department of Clinical Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
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Yang M, Rao HY, Feng B, Zhang W, Wei L. Impact of interleukin 28B polymorphisms on spontaneous clearance of hepatitis C virus infection: a meta-analysis. J Gastroenterol Hepatol 2013; 28:1114-21. [PMID: 23611115 DOI: 10.1111/jgh.12233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2013] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIM Recent studies suggested that interleukin 28B (IL28B) polymorphisms may affect spontaneous clearance (SC) of hepatitis C virus (HCV) infection. Our purpose was to update the meta-analysis to reevaluate the impact of IL28B rs12979860 and rs8099917 polymorphisms on SC in patients infected with HCV. METHODS We searched PubMed, Web of Science, and Embase up to February 2013. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated by fixed- or random-effects models. Heterogeneity, sensitivity analysis, and publication bias were also assessed. RESULTS Seventeen eligible papers were involved in this study. The SC rate was higher in patients with the rs12979860 CC (vs CT/TT OR = 2.98, 95% CI 2.53-3.50) and rs8099917 TT (vs GT/GG OR = 2.80, 95% CI 2.23-3.51) in the IL28B polymorphisms. Ethnicity stratification revealed that rs12979860 CC was associated with SC for Caucasians (vs CT/TT OR = 3.05, 95% CI 2.67-3.49), Asians (vs CT/TT OR = 1.88, 95% CI 1.33-2.66), and Africans (vs CT/TT OR = 3.15, 95% CI 2.39-4.15); rs8099917 TT was associated with SC for Caucasians (vs GT/GG OR = 2.48, 95% CI 1.96-3.15). CONCLUSIONS IL28B rs12979860 and rs8099917 single nucleotide polymorphisms are significantly associated with SC of HCV infection. The predictive value of rs12979860 CC was stronger in Caucasians and Africans than in Asians.
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Affiliation(s)
- Ming Yang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University, Beijing, China
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Jiménez-Sousa MA, Berenguer J, Rallón N, Guzmán-Fulgencio M, López JC, Soriano V, Fernández-Rodríguez A, Cosín J, Restrepo C, García-Álvarez M, Miralles P, Benito JM, Resino S. IL28RA polymorphism is associated with early hepatitis C virus (HCV) treatment failure in human immunodeficiency virus-/HCV-coinfected patients. J Viral Hepat 2013; 20:358-66. [PMID: 23565619 DOI: 10.1111/jvh.12041] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/29/2012] [Indexed: 12/12/2022]
Abstract
Due to the poor rate of response to hepatitis C virus (HCV) with pegylated interferon and ribavirin treatment in HCV/HIV coinfected patients, key factors for predicting failure would be useful. We performed a retrospective study on 291 patients on HCV treatment, who had early virological response (EVR) data. IL28B and IL28RA polymorphisms were performed using the GoldenGate(®) assay. Unfavourable genotypes at IL28B (rs12980275 AG/GG and rs8099917 GT/GG) and an unfavourable allele at IL28RA (rs10903035 G) were associated with early treatment failure. However, only the rs12980275 AG/GG genotype and rs10903035 G allele remained independently associated with early failure in the overall population (OR = 4.15 (95% CI = 1.64-10.54) and OR = 2.00 (95% CI = 1.19-3.36), respectively) as well as in GT1/4 patients (OR = 5.07 (95% CI = 1.81-14.22) and OR = 2.03 (95% CI = 1.13-3.66), respectively). Next, a decision tree showed early treatment failure increased from 37.1% to 65.5% when the unfavourable rs12980275 AG/GG and rs10903035 AG/GG genotypes and HCV-RNA≥ 500.000 IU/mL were taken into account in GT1/4 patients. In contrast, the failure rate decreased from 37.1% to 11.9% when the favourable rs12980275 AA and rs10903035 AA genotypes were detected. The percentage of patients correctly classified was 78.4%, and AUROC was 0.802 ± 0.028. Regarding GT3 patients, the presence of the GCGCA haplotype (all unfavourable alleles) was associated with early treatment failure, while no association was observed for the IL28B polymorphisms. In conclusion, the IL28RA polymorphism was associated with early treatment failure independently of the IL28B SNPs. The combination of IL28B and IL28RA polymorphisms might be a valuable tool for predicting early treatment failure before starting HCV treatment.
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Affiliation(s)
- M A Jiménez-Sousa
- Unit of HIV/Hepatitis Coinfection, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28220, Spain
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Boesecke C, Wedemeyer H, Rockstroh JK. Diagnosis and treatment of acute hepatitis C virus infection. Infect Dis Clin North Am 2013; 26:995-1010. [PMID: 23083829 DOI: 10.1016/j.idc.2012.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The first 6 months after exposure to hepatitis C virus (HCV) are regarded as acute hepatitis C (AHC). Two patient populations worldwide share the highest prevalence of AHC virus infection: injection drug users and HIV-positive men who have sex with men. Diagnosis of AHC is often difficult in both patient populations as the acute inflammatory phase can be clinically asymptomatic and patients at highest risk for acquiring AHC (injection drug users) tend to evade regular medical care. This article addresses similarities and differences in the epidemiology, diagnosis, and management of AHC monoinfection and coinfection.
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Affiliation(s)
- Christoph Boesecke
- Department of Internal Medicine I, Bonn University Hospital, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
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