Paradoxical alteration of acute-phase protein levels in patients with chronic hepatitis C treated with IFN- 2b

Abstract

Previously we observed elevation of the serum concentration of two acute-phase protein (AFP) complement components (C9 and C1-inhibitor) in patients with chronic hepatitis C who responded (R) to IFN-alpha therapy, but not in non-responders (NR). In the present study we investigated the effect of high-dose IFN-alpha therapy on serum concentrations of two positive [orosomucoid (OROSO) and C-reactive protein (CRP)] and two negative [transferrin (TF) and fetuin/alpha2HS-glycoprotein (AHSG)] AFP in an outpatient setting. We investigated blood samples of 40 patients with chronic hepatitis C at the onset and at the end of a 3-month treatment with high-dose IFN-alpha2b (5 MIU/day for 6 weeks, followed by 5 MIU t.i.w.) and of 52 healthy individuals. Serum concentrations of OROSO, TF and AHSG were measured by radial immunodiffusion; CRP levels were determined by immunotubridimetry. Compared to controls, patients with chronic hepatitis C had significantly lower OROSO and CRP, and higher AHSG levels. By the end of treatment, OROSO concentration increased in R (P = 0.0054), but not in NR patients. In contrast, TF levels decreased in R (P = 0.0040), but did not change in NR patients. Similarly, in R patients, AHSG levels tended to decrease (P = 0.0942) following IFN-alpha treatment. We conclude that the acute-phase reaction is suppressed in patients with chronic hepatitis C that may be potentially related to the responsiveness to IFN-alpha therapy.

The role of circulating monocyte chemoattractant protein-1 as a marker of hepatic inflammation in patients with chronic liver disease

“…Previous studies have shown different patterns of CRP alteration according to the type of liver disease. Thus, it has been reported to be increased in alcoholic hepatitis [3], unchanged in non-alcoholic steatohepatitis [11], and decreased in chronic hepatitis C [12]. Most of our patients had liver disease secondary to hepatitis C virus infection, providing an explanation for the observed trend of decreased CRP concentrations.…”

Anti-C-reactive protein antibodies in chronic hepatitis C infection: Correlation with severity and autoimmunity

“…In chronic hepatitis C, levels of some acute-phase protein, such as C5b-9 levels, CH50, specific C4 activity, and CRP were lower than controls. Interestingly, some of these changes were reversible in patients who responded to HCV treatment [13][14][15].…”

Hepatitis C virus coinfection and the risk of cardiovascular disease among HIV‐infected patients

“…Also, patients with chronic HCV monoinfection have lower rates of lipid abnormalities than age-and sex-matched healthy subjects [22], and LDL-C concentrations were inversely correlated with the severity of liver disease [23]. Hepatitis C has also been associated with lower C-reactive protein (CRP) levels in both HIVnegative and HIV-positive subjects [24,25]. The beneficial impact of HCV coinfection on lipids and CRP -two independent predictors of cardiovascular disease -has led some to postulate that HCV coinfection may, to some extent, ameliorate the increased cardiovascular risk associated with HIV infection and HAART use [24].…”