Abstract
Prevalence of Hepatitis C virus (HCV) in Egypt is 22% as reported by World Health Organization (WHO) 2012. Interferon (IFN)-based treatments are currently the main therapeutic option. However, depending upon variations in their human leukocyte antigen (HLA), some patients do not respond well to IFN therapy. The current study evaluated some HLA class II alleles among 200 HCV positive individuals from Alexandria, Egypt, who were receiving standard IFN therapy. In this study, 30 patients (33.3 %) showed a sustained virological response (SVR) to IFN therapy, whereas 30 (33.3 %) did not and 30 (33.3%) cleared the virus spontaneously. 30 unrelated healthy volunteers served as controls. DNA was extracted by spin column method from lysed blood of all enrollees for HLA-DRB1 and HLADQB1 allele typing by sequence specific oligonucleotide probe (SSOP), whilst plasma was used for HCV quantitation by real time polymerase chain reaction (RT-PCR) and genotyping by line probe assay INNO LiPA (Innogenetics). HLA-DRB1*03 individually (p=0.025) or in combination HLA-DRB1*04 (p=0.035) revealed to be significant protective alleles against HCV infection. In patients on IFN therapy, HLA-DRB1*11 was significantly associated with viral clearance. In contrast, HLA-DRB1*07 (p=0.005) was associated with viral persistence. We can conclude that certain HLA class II alleles could predict response to IFN therapy as early as possible before starting treatment of chronic HCV cases and can be used as successful guide to clinicians in deciding the therapeutic regimen for Egyptian patients infected with HCV genotype 4.
Highlights
Human Leukocyte Antigens (HLA) are encoded by a complex of genes, which are among the most polymorphic regions of the human genome
Several HLA alleles have been found to be associated with susceptibility and resistance to hepatitis C virus (HCV) infection, pathogenesis leading to liver damage, cirrhosis and the response to IFN therapy but their results were inconsisten [2,3,4]
We have analyzed HCV clearance or persistence with HLA class II antigens of patients on pegylated Interferon therapy infected with HCV genotype 4
Summary
HLAs are encoded by a complex of genes, which are among the most polymorphic regions of the human genome. Several HLA alleles have been found to be associated with susceptibility and resistance to HCV infection, pathogenesis leading to liver damage, cirrhosis and the response to IFN therapy but their results were inconsisten [2,3,4]. HLA class I and II antigens are central to human immune response and ideal candidate genes to investigate for association with HCV outcomes [10]. The current study aimed at testing several HLA alleles to detect clearance from persistance ones responsible for failure of treatment. This may aid clinicians in choosing successful line of therapy suitable for each case as early as possible saving money and complications of non responders
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