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da Silva Sacerdote AB, Filgueira NA, de Barros Barreto S, Batista AD, Lopes EP. Anti-rod and ring antibodies in patients with chronic hepatitis C using direct-acting antivirals. Immunol Res 2020; 68:111-117. [PMID: 32537670 DOI: 10.1007/s12026-020-09136-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Anti-rods and rings (anti-RR) antibody induction is related to the combination of interferon and ribavirin in the treatment of hepatitis C virus (HCV) infection. If the main factor leading to this autoimmune reaction is the combination of these drugs, is not well known, but in vitro studies shows that ribavirin alone can induce rods and rings structures. New direct-acting antivirals (DAAs) permit HCV treatment without needing interferon but may be associated with ribavirin in the most difficult-to-treat patients. The aim of this study is to evaluate the occurrence of anti-RR in patients with chronic HCV infection, before and after 12 weeks of treatment with DAAs, with and without ribavirin. From Jun 2016 to Oct 2017, 52 HCV-infected patients were screened for anti-RR before and after DAA therapy, including sofosbuvir, daclatasvir, simeprevir, and ribavirin. Serum samples were analyzed using indirect immunofluorescence. The anti-RR was present in 11 (21%) of the 52 patients (51.9% male and mean age of 59.1 years) before using DAAs. All of them had been previously treated and previous exposed to interferon/ribavirin, with exposure time to ribavirin associated with the presence of anti-RR. After 12 weeks of DAA treatment, 3 patients (5.7%) developed the antibody in low titers, and two of them (66%) were interferon/ribavirin experienced. Only one of the 29 naïve patients (3.44%) developed anti-RR during the current treatment. Anti-RR was present in patients previously treated with interferon/ribavirin and can emerge after DAA treatment probably at a lower frequency than after interferon/ribavirin treatment.
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Affiliation(s)
- Ana Beatriz da Silva Sacerdote
- Program in Health Sciences, Universidade Federal de Pernambuco (UFPE), Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil.
| | - Norma Arteiro Filgueira
- Department of Internal Medicine, Center of Medical Sciences, UFPE, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
| | - Silvana de Barros Barreto
- Clinical Laboratory, Hospital das Clínicas, UFPE, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
| | - Andréa Dória Batista
- Department of Internal Medicine, Center of Medical Sciences, UFPE, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
| | - Edmundo Pessoa Lopes
- Department of Internal Medicine, Center of Medical Sciences, UFPE, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
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da Silva Sacerdote AB, Filgueira NA, de Barros Barreto S, Batista AD, Lopes EP. Long-term persistence of anti-rods and rings antibodies in patients with chronic hepatitis C after antiviral treatment. Immunol Res 2019; 66:605-610. [PMID: 30220012 DOI: 10.1007/s12026-018-9026-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Anti-rods and rings (anti-RR) antibodies are related to hepatitis C virus (HCV) in patients treated with pegylated interferon (PEG-IFN) and ribavirin (RBV). Only RBV induces rods/rings structures in vitro; but in vivo, the antibody appearance is related to the combination of these drugs, because data about patients using just one of these drugs alone is missing. Some studies suggest disappearance of these antibodies over time. The aim of this study was to describe the occurrence of anti-RR in patients with chronic hepatitis C treatment-naïve or previously PEG-IFN/RBV-experienced, evaluating the persistence of anti-RR antibodies long after PEG-IFN/RBV treatment. From 2016 to 2017, 70 HCV-infected patients were screened for anti-RR using indirect immunofluorescence. Demographic and clinical data about previous treatments against HCV were assessed. Thirty-four patients (49%) had been previously treated with PEG-IFN/RBV and the average time since they had received the last antiviral treatment was 85.4 months. Anti-RR seropositivity was detected in 16 patients (23%), and all of these had used PEG-IFN/RBV (corresponding to 47% of experienced patients). Previous antiviral treatment and previous exposure time to RBV were associated with anti-RR positivity. Median time elapsed since last treatment was similar between anti-RR-positive and anti-RR-negative patients. Anti-RR seropositivity was not observed in treatment-naïve patients, but was detected in almost half of patients previously treated with PEG-IFN and RBV, even after a long period without exposure to these drugs. This antibody was related to extended prior exposure to ribavirin.
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Affiliation(s)
- Ana Beatriz da Silva Sacerdote
- Postgraduate Program in Health Sciences Center, Universidade Federal de Pernambuco, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil.
| | - Norma Arteiro Filgueira
- Department of Gastroenterology and Hepatology, Hospital das Clínicas, Universidade Federal de Pernambuco, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
| | - Silvana de Barros Barreto
- Clinical Laboratory, Hospital das Clínicas, Universidade Federal de Pernambuco, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
| | - Andréa Dória Batista
- Department of Gastroenterology and Hepatology, Hospital das Clínicas, Universidade Federal de Pernambuco, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
| | - Edmundo Pessoa Lopes
- Department of Gastroenterology and Hepatology, Hospital das Clínicas, Universidade Federal de Pernambuco, Av. Professor Moraes Rego, 1235, Recife, PE, 50670-901, Brazil
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Oliveira SBD, Merchán-Hamann E, Amorim LDAF. HIV/AIDS coinfection with the hepatitis B and C viruses in Brazil. CAD SAUDE PUBLICA 2014; 30:433-8. [PMID: 24627070 DOI: 10.1590/0102-311x00010413] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 08/26/2013] [Indexed: 11/21/2022] Open
Abstract
The aim of this study is to estimate the prevalence of HIV/HBV and HIV/HCV coinfections among AIDS cases reported in Brazil, and to describe the epidemiological profile of these cases. Coinfection was identified through probabilistic record linkage of the data of all patients carrying the HIV virus recorded as AIDS patients and of those patients reported as carriers of hepatitis B or C virus in various databases from the Brazilian Ministry of Health from 1999 to 2010. In this period 370,672 AIDS cases were reported, of which 3,724 were HIV/HBV coinfections. Women are less likely to become coinfected than men and the chance of coinfection increases with age. This study allowed an important evaluation of HBV/HIV and HCV/HIV coinfections in Brazil using information obtained via merging secondary databases from the Ministry of Health, without conducting seroprevalence research. The findings of this study might be important for planning activities of the Brazilian epidemiologic surveillance agencies.
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Affiliation(s)
| | - Edgar Merchán-Hamann
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brasil, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brasil
| | - Leila Denise Alves Ferreira Amorim
- Instituto de Matemática, Universidade Federal da Bahia, Salvador, Brasil, Instituto de Matemática, Universidade Federal da Bahia, Salvador, Brasil
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Hsieh MY, Dai CY, Lee LP, Huang JF, Chuang WL, Hou NJ, Lin ZY, Chen SC, Hsieh MY, Wang LY, Chang WY, Yu ML. Antinuclear antibody titer and treatment response to peginterferon plus ribavirin for chronic hepatitis C patients. Kaohsiung J Med Sci 2012; 28:86-93. [PMID: 22313535 DOI: 10.1016/j.kjms.2011.10.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 02/10/2011] [Indexed: 02/08/2023] Open
Abstract
Positive serum antinuclear antibody (ANA) is not infrequent in chronic hepatitis C virus (HCV)-infected patients. This prospective study evaluated the impact of ANA on the response to and safety of peginterferon/ribavirin combination therapy for chronic hepatitis C patients in clinical practice. We enrolled 243 consecutive patients who were treated with a 24-week regimen of peginterferon-α plus ribavirin, with a 24-week follow-up period. ANA titer was determined before antiviral treatment. The primary end-point was sustained virological response (SVR), defined as HCV RNA <50 IU/mL throughout the follow-up period. Overall, 187 (77.0%) patients experienced a SVR. In the 105-patient HCV genotype non-1 group, patients with ANA titer ≥1:80 had a significantly lower SVR rate than those with ANA titer <1:80 (67.7% vs. 95.8%, respectively, p = 0.013). In contrast, in the 138-patient HCV genotype 1 group, the SVR rate did not differ between patients with and without ANA titer ≥1:80. Multivariate regressive analyses showed that ANA ≥1:80, age and HCV RNA levels were independent factors associated with SVR in HCV genotype non-1 patients; whereas HCV RNA levels and hepatic fibrosis were prognostic predictors of SVR in HCV genotype 1 patients. The frequencies of adverse events were similar between patients with and without ANA seropositivity. Peginterferon/ribavirin combination therapy is effective and safe in ANA-positive chronic hepatitis C patients. A high ANA titer was a negative prognostic factor for treatment response in HCV genotype non-1 patients.
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Affiliation(s)
- Ming-Yen Hsieh
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
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Wasmuth HE, Stolte C, Geier A, Dietrich CG, Gartung C, Lorenzen J, Matern S, Lammert F. The presence of non-organ-specific autoantibodies is associated with a negative response to combination therapy with interferon and ribavirin for chronic hepatitis C. BMC Infect Dis 2004; 4:4. [PMID: 15040810 PMCID: PMC373450 DOI: 10.1186/1471-2334-4-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2003] [Accepted: 02/13/2004] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Non-organ-specific autoantibodies are found in a considerable number of anti-HCV positive patients. Previous studies investigated the clinical relevance of these antibodies in patients treated with interferon monotherapy, but not combination therapies. METHODS Anti-nuclear, anti-smooth muscle, anti-mitochondrial, anti-neutrophil-cytoplasmatic and anti-liver/kidney microsomal antibodies were determined in 78 consecutive anti-HCV positive patients by indirect immunofluorescence. The presence of these antibodies was related to demographic variables and to the outcome of antiviral combination therapy with interferon-alpha and ribavirin in 65 patients. RESULTS In our study, positivity for autoantibodies was associated with higher alanine aminotransferase levels and higher mean values for HCV-RNA (p < 0.01). Furthermore, negativity for non-organ-specific autoantibodies was associated with a favourable treatment outcome of combination therapy with at least one negative RT-PCR for HCV-RNA during treatment (OR 4.65, 95% CI 1.31 to 16.48, p = 0.02). ANA and SMA staining patterns and titers were not correlated to treatment response. With multiple logistic regression analysis, positivity for autoantibodies and HCV genotype were independently associated with outcome of antiviral combination therapy (p = 0.02). CONCLUSIONS The absence of non-organ-specific autoantibodies might indicate a significantly higher chance for viral clearance in response to combination therapy for chronic hepatitis C infection. Therefore, despite of an overall higher treatment response, the addition of the immunomodulatory drug ribavirin could accentuate immunological differences that affect treatment outcome and might have been less obvious in earlier studies analysing interferon monotherapy.
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Affiliation(s)
- Hermann E Wasmuth
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Christian Stolte
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Andreas Geier
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Christoph G Dietrich
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Carsten Gartung
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Johann Lorenzen
- Institute of Pathology, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Siegfried Matern
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
| | - Frank Lammert
- Department of Internal Medicine III, University Hospital Aachen (UKA), Aachen University (RWTH), Aachen, Germany
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