Abstract
Hepatitis C Virus (HCV) infection is one of the main causes of chronic liver disease worldwide. Egypt has the highest prevalence of Hepatitis C Virus (HCV) in the world, estimated nationally at 14.7%. knowledge of the predictors of Sustained Viral Response (SVR) to Pegylated Interferon (PEG-INF) and Ribavirin (RBV) therapy in patients with chronic hepatitis C is crucial for selecting patients who would benefit most from therapy especially in developing country as Egypt where the highest percentage of treatment cost funded by government. This study was performed on Egyptian patients with chronic active hepatitis C who were prepared for receiving a course of treatment with: Interferon (PEG IFN) and ribavirin for 48 weeks. We aimed to find more predictive markers those can help clinicians to choose the most effective treatment program for each patient. Assessment of HLA-DRB1, HLA-DQB1 genes by Sequence Specific Primer (SSP) PCR, interleukin-10 (IL-10) by ELISA technique and Serum HCV RNA load by TaqMan Real Time RT-PCR technology were done. We found that sustained responders were significantly among DRB1*13 allele and DQB1*02 typing (p<0.001). DRB1*07 allele only appeared with responded patients. Relations were found between response to treatment and lower IL-10 level and lower Body Mass Index (BMI) but not sufficient to reach to significant value. In conclusion, we emphasize the importance of the use of pharmacogenomic data in the treatment of patients. HLA-DRB1*07, HLA-DRB1*13 and HLA-DQ02 alleles can predict the response to HCV combined therapy. The data generated from our study may be helpful in future for clinicians to predict the treatment outcome for HCV-seropositive individuals in Egypt.
Highlights
Hepatitis C Virus (HCV) infection is one of the main causes of chronic liver disease worldwide (Lavanchy, 2011)
The study protocol was approved by the Ethical Review Committee (ERC) of Faculty of Medicine, Benha University and by National Committee for control of viral hepatitis of Egyptian Ministry of Health, Egypt and written informed consent was obtained from all participants
The goal of therapy is to eradicate HCV infection in order to prevent the complications of HCV-related liver and extra-hepatic diseases, including hepatic necroinflammation, fibrosis, cirrhosis, decompensation of cirrhosis, hepatocellular carcinoma and death
Summary
Hepatitis C Virus (HCV) infection is one of the main causes of chronic liver disease worldwide (Lavanchy, 2011). The long-term impact of HCV infection is highly variable, ranging from minimal histological changes to extensive fibrosis and cirrhosis with or without Hepatocellular Carcinoma (HCC). The number of chronically infected persons worldwide is estimated to be about 160 million, but most are unaware of their infection (EASL, 2014). Hepatitis C Virus genotype 4 (HCV-4) is the most common variant of the hepatitis C virus (HCV) in the Middle East and Africa, Egypt. This region has the highest prevalence of HCV worldwide, with more than 90% of infections due to genotype-4 (Kamal and Nasser, 2008).
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