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 HLA-DQB1 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.
Abstract:Although antiphospholipid (APL) antibodies are still not clearly known, yet they have association with thromboembolic events associated with hepatitis C virus (HCV) infection. Moreover, high percent of HCV infections and thromboembolic risk was associated among thalassemic patients. So our aim was to screen and evaluate the significance of ACL and anti β-2 glycoprotein seroprevelance among patients receiving repeated blood transfusions, in patients with infectious diseases as chronic HCV disorders, and in healthy subjects resident in Egypt, a tropical country endemic for hepatitis and to evaluate these tests as rapid markers for early detection of thrombotic HCV infection among chronic liver disorders and cases receiving repeated blood transfusion aiming at early anticoagulant therapy.The study was carried out on 70 patients attending Tropical, Hepatology and Hematology departments in Alexandria Main University Hospital, Egypt as well as 30 healthy subjects served as controls. Group I; 35 chronic liver disorders as chronic HCV, cirrhosis and Hepatocellular carcinoma(HCC) diagnosed by clinical, ultrasound and histopathology. Group II ; 35 receiving repeated blood transfusion as thalassemia. Group III; healthy relatives -ve for HCV antibody of matched age and sex. Both markers were screened by commercial enzyme immunosorbant assays (ELISA) (Calbiotech,USA). Our results revealed that patients with chronic HCV infection had higher anticardiolipin (ACL) IgG and antibeta2GP1 IgG compared to healthy controls. (26.6%) 8 patients from group I had high ACL IgG compared to 6 patients (20%) of group II .The study also revealed that anti β-2 glycoprotein IgG was higher among Group I and II compared to controls group III. Group I was higher than group II. Three patients (10%) of group I had high antiβ2 glycoprotein1 IgG compared to 2 patients (6.6%) among group II . We can conclude that anticardiolipin (ACL)alone is not diagnostic for thrombosis & it should be accompanied with antibeta(β )2glycoprotein-1 in serum of the same patient to be considered a cause of thrombosis in chronic HCV patients. So, ACL alone can not be considered rapid marker of thrombosis in HCV positive patients. We recommend anti β2 glycoprotein as a biomarker predicting thrombotic HCV infection.
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