Neutrocyte-to-lymphocyte ratio predicts the presence of a replicative hepatitis C virus strand after therapy with direct-acting antivirals

Autor: Krzysztof P. Bielawski, Małgorzata Cheba, Beata Lorenc, Katarzyna Sikorska, Anna Wróblewska
Rok vydání: 2019
Předmět:
Adult
Male
0301 basic medicine
medicine.medical_specialty
Sustained Virologic Response
Neutrophils
Short Communication
Hepatitis C virus
Lymphocyte
Lymphoproliferative disorders
Inflammation
Hepacivirus
Direct-acting antivirals
medicine.disease_cause
Antiviral Agents
Peripheral blood mononuclear cell
General Biochemistry
Genetics and Molecular Biology
Decision Support Techniques
Leukocyte Count
03 medical and health sciences
0302 clinical medicine
Immune system
Interferon
Internal medicine
medicine
Humans
Lymphocytes
Interferon lambda
Aged
Replicative HCV-RNA strand
Occult hepatitis C infection
Hematology
business.industry
General Medicine
Hepatitis C
Chronic
Middle Aged
medicine.disease
Neutrocyte-to-lymphocyte ratio
030104 developmental biology
medicine.anatomical_structure
030220 oncology & carcinogenesis
Immunology
RNA
Viral
Female
Drug Monitoring
medicine.symptom
business
Follow-Up Studies
medicine.drug
Zdroj: Clinical and Experimental Medicine
ISSN: 1591-9528
1591-8890
DOI: 10.1007/s10238-019-00561-y
Popis: Residual HCV-RNA can persist in liver tissue and peripheral blood mononuclear cells (PBMCs) long after antiviral therapy of chronic hepatitis C in patients repeatedly negative for viral RNA in serum. This occult infection associates with impaired immune response and the risk of lymphoproliferative disorders or progressive liver disease. There are currently no monitoring strategies for patients after treatment. We investigated if serum inflammation markers and interferon lambda (IFNL) genotype can be predictors of the presence of HCV-RNA and the replicative HCV-RNA (−) strand in patients who reached sustained virological response after interferon-free therapy. Forty-two consecutive patients who remained HCV-RNA negative in serum 24 weeks after the end of treatment (EOT) and during the follow-up were enrolled. Total HCV-RNA and HCV-RNA (−) strand were detected using ultrasensitive RT-PCR in PBMCs collected 12–15 months after EOT. Polymorphisms within IFNL3–IFNL4 region (rs12979860 and ss469415590) were genotyped with allele-specific PCR. Viral RNA was found in PBMCs from 31 (74%) patients, and of those 29 (69%) were also positive for HCV-RNA (−). Neither normalization of alanine aminotransferase nor IFNL genotype predicted the presence of residual HCV-RNA. A significantly higher neutrocyte-to-lymphocyte ratio (NLR) 24 weeks after the start of treatment predicted elimination of replicative HCV-RNA strand (OR 0.23; 95% CI 0.10–0.86; P = 0.019). Patients with no HCV-RNA (−) in PBMCs showed a greater increase in neutrocyte count between EOT and baseline (P = 0.028). Lack of significant elevation of NLR after therapy with direct-acting antivirals could predict the presence of residual replicative HCV-RNA strand in PBMCs. Electronic supplementary material The online version of this article (10.1007/s10238-019-00561-y) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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