Abstract

Herein, we examined the association between cytomegalovirus (CMV) coinfection and the progression of liver fibrosis in hepatitis C virus (HCV) infection, and investigated the effect of CMV coinfection on JAK-STAT pathway. CMV DNAemia was detected by PCR in DNA from controls (n = 120), and HCV patients with early (F0-F1, n = 131) and late (F2-F4, n = 179) liver fibrosis. By quantitative real time PCR (qRT-PCR), we examined the profile of 8 JAK-STAT transcripts in PBMCs RNA from 90 HCV patients (39 CMV positive and 51 CMV negative), 4 CMV mono-infected patients, and 15 controls. Our results demonstrated higher incidence of CMV in F2-F4 group than in control (OR 5.479, 95% CI 3.033–9.895, p < 0.0001) or F0-F1 groups (OR 2, 95% CI 1.238–3.181, p = 0.005). qRT-PCR showed downregulation of STAT2 (p = 0.006) and IRF7 (p = 0.02) in CMV positive group compared to CMV negative one. The downregulation of STAT2 and IRF7 was mainly in CMV positive patients with late fibrosis compared to CMV negative patients (p = 0.0007 for IRF7 and p = 0.01 for STAT2). Our results are the first to report that CMV coinfection is a possible risk factor for the progression of HCV-induced liver fibrosis, and thereby CMV screening and treatment are important for HCV patients.

Highlights

  • Hepatitis C virus (HCV) infection is a significant public health problem that affects as many as 170 million cases worldwide[1]

  • Understanding the key factors regulating the progression of liver fibrosis in hepatitis C virus (HCV) infection is a real challenge

  • We explored in our previous studies increased occurrence of CMV coinfection in HCV-patients responding poorly to IFN-based therapeutics[21] and treatment-naïve patients with HCC22

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Summary

Introduction

Hepatitis C virus (HCV) infection is a significant public health problem that affects as many as 170 million cases worldwide[1]. Once IFNα/β bind to their common heterodimeric receptor (IFNAR1/IFNAR2), they stimulate the signaling cascade of JAK-STAT pathway, mediating by the activation of JAK1 and TYK2, and ending in the formation of ISGF3 complex (IRF9, STAT1, and STAT2) The latter plays a key role in regulating the transcription of IFN-stimulated genes (ISGs), with the consequent killing of virus-infected cells and restricting virus replication[15]. Among these ISGs is IRF7, which works through a feed-back mechanism to induce the mRNA expression of a second wave of IFNα/β. CMV inhibits STAT2-dependent gene expression[20]

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