Effect of direct-acting antiviral medications on α-fetoprotein, IL-10, and VEGF as predictors of HCC in HCV-infected hemodialysis patients

Abstract

Background Hepatitis C virus (HCV) is considered one of the major causes of chronic liver disease in Egypt. HCC is a common complication of liver cirrhosis; it is the most common malignant neoplasm among Egyptian males and the second one in Egyptian females. The aim of the current study is to investigate the effect of our national DAA treatment protocol on the serum levels of IL-10, and VEGF in HCV infected hemodialysis patients. Patients and methods This study was carried out in Alexandria, Egypt. 85 subjects were enrolled in this study and divided into three groups. The first group was the control group, it included 25 healthy subjects, the second group included 50 hemodialysis patients infected with chronic HCV G4, they received DAAs therapy for 12 weeks, and the third group comprises 10 HCV chronic hemodialysis patients with HCC. Results Sustained viral response (SVR12) had been achieved in 43 patients (86%) in group two. There was a clear increase in the serum level of IL 10, and VEGF in HCV+HD and HCV+HD+HCC from control (P<0.001) Logistic regression analysis showed that serum IL10, and VEGF could be utilized as predictor marker of (HCV+HD and HCV+HD+HCC) group from control and for HCV+HD from control ROC analysis detected 90% sensitivity and 92 % specificity to discriminate between healthy subjects and HCV+HD+HCC group. Conclusion Study demonstrated that high levels of IL-10 and VEGF in both HCV+HD and HCV+HD+HCC (higher levels) patients. Attainment of SVR12 with combination of ombitasvir paritaprevir, and ritonavir plus ribavirin in HCV+HD is potential without major side effects, and it was achieved regardless the serum levels of IL-10 or VEGF.