Background
IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients in the non-transplant setting.
Objective
To determine the prevalence and impact on clinical outcomes of donor and recipient IL28B genotypes among liver transplant recipients receiving directly acting antiviral therapy compared to those of HCV non-transplant patients.
Patient and Methods
This study included 60 patients divided into 2 groups: group 1 included 30 patients subjected to living donor liver transplantation and group 2 included 30 patients of HCV infection. Each group was subdivided into group A and group B according to the regimen of directly acting antiviral therapy (sofosbuvir-ledibasvir, sofosbuvir-daclatasvir). Liver transplantation was done between January 2016 and April 2018. Genotyping of the polymorphism was performed on DNA collected from all donors and recipients in group 1 before and after liver transplantation and also collected from all patients of group 2. Sustained virological response was found in 28 patients in group 1 (transplanted group) and 29 patients in group 2 (non-transplanted group) with no significant difference.
Results
No significant difference also was found in both groups according to the type of regimen. Also the type of genotype CC, CT and TT of IL28B in donors and recipients were not significantly associated or affecting the results of SVR in both groups of patients.
Conclusion
Our results support no role of recipient IL28B genotype in the response to directly acting antiviral drugs for hepatitis C recurrence. Interestingly, donor genotype seems not to influence the response pattern in recipients who have different IL28B genotype.
BackgroundHepatitis C virus (HCV) is a common disease in Egypt with a high socioeconomic burden and extra-hepatic manifestations as QT prolongation, but previous studies included mainly patients with advanced liver disease, so in this study, we aimed to delineate the prevalence of QT prolongation in early-stage HCV patients.ResultsThe study included 874 HCV patients with early cirrhosis; in Child’s class A, 57 (6.5%) patients had prolonged QT interval corrected (QTc). There was significant higher proportion of cirrhotic patients in the prolonged QTc group (31.6%) vs. in the normal QTc group (11.5%). QTc was 424.39 ± 36.6 vs. 411.51 ± 32.89 ms in cirrhotic and non-cirrhotic patients, respectively (P, 0.001). There was significant higher proportion of Fibrosis 4 (FIB-4) ≥ 1.45 score in the prolonged QTc (77.2%) vs. in the normal QTc group (56.8%) (P, 0.003). QTc interval was 417.76 ± 34.12 ms in patients with FIB-4 score ≥ 1.45 vs. 406.78 ± 31.95 ms in those with FIB-4 < 1.45 (P, < 0.001). FIB-4 score value of 2.108 predicted prolonged QTc with a sensitivity of 63.2% and a specificity of 64.5% (P, < 0.001). Twenty-four patients of long QTc group sent ECGs after HCV eradication, and 19 patients (79%) showed QTc normalization.ConclusionsHCV is associated with QTc prolongation even in patients with early chronic liver disease stages without significant fibrosis. Also, it is related to the degree of fibrosis and cirrhosis. At a cutoff value of 2.108, FIB-4 score can predict prolonged QTc. HCV eradication is associated with a high incidence of QTc normalization.
Following publication of the original article [1], the authors reported that the family name of Mohamed El Kassas was incorrectly published as Mohamed ElKassas.
The Hepatitis C virus (HCV) has a major impact on public health and is thought to be responsible for 25% of hepatocellular carcinoma (HCC) and 27% of cirrhosis cases worldwide. Recent direct-acting antivirals (DAAs) for hepatitis C have the potential to reduce this disease burden, but there are increased worries about HCC incidence in HCV patients receiving DAAs. This work assessed the HCC incidence in HCV patients treated with DAAs and its relationship to Hepatic Fibrosis Stage.The study included 400 chronic HCV patients equally divided into two groups: chronic HCV patients who did not receive anti HCV medication (control group) and chronic HCV patients who received different DAAs treatment regimens. There was a highly significant difference between both groups as regards hepatic fibrosis stages before DAAs therapy. The DAA receiving group had highly statistically advanced hepatic fibrosis when compared to the control group. After eighteen months of follow up, the DAA receiving group had a significantly lower incidence of HCC when compared to the control group (5.5% versus 11% respectively, p-value 0.04).
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