No abstract

In chronically infected HCV patients emergence and evolution of fibrosis, as a consequence of virus persistence, can be considered as an indicator of disease advancement. Therefore the aim of this study was to correlate alterations of immune response in chronic HCV patients with liver histopathology. Sera cytokine levels and frequency of circulating and liver infiltrating cells were evaluated using 13plex Kit Flow Cytomix, flow cytometry and immunohistochemistry. We found that the number of circulating T lymphocytes (including CD4+, CD8+ and Treg) and B lymphocytes, as well as DCs, was higher in patients with no fibrosis than in healthy subjects. In patients with fibrosis frequency of these cells decreased, and contrarily, in the liver, number of T and B lymphocytes gradually increased with fibrosis. Importantly, in patients with advanced fibrosis, liver infiltrating regulatory T cells and DC-SIGN+ mononuclear cells with immunosuppressive and wound-healing effector functions were abundantly present. Cytokine profiling showed predominance of proinflammatory cytokines in patients with no fibrosis and a tendency of decline in level of all cytokines with severity of liver injury. Lower but sustained IL-4 production refers to Th2 predominance in higher stages of fibrosis. Altogether, our results reveal graduall alterations of immunological parameters during fibrosis evolution and illustrate the course of immunological events through disease progression.

The results of our study showed that the treatment outcome of chronic HCV infection was associated with baseline HCV ribonucleic acid, HCV genotype, route of infection and the degree of histopathological changes in the liver.

No abstract

Treatment of patients suff ering from chronic hepatitis C with standard pegylated interferon alpha 2a plus ribavirin has limited effi cacy. erapy outcome is dependent on several factors of both the host and virus, including age, sex, stage of fi brosis, viral genotype, viral load, and occurrence of haematological adverse events during chronic hepatitis C treatment. e aim of this study was to determine the relationship between the viral and host factors and the haematological side eff ects of therapy with sustained virological response.Fifty-four patients were treated with combined pegylated interferon alpha 2a plus ribavirin therapy. Hepatitis C virus genotyping, viral load, histopathological liver changes and biochemical parameters were evaluated for each patient before beginning treatment. Each patient's blood count was analysed during each clinical visit.Sustained virological response was achieved in 75,9% of patients. Baseline AST and ALT levels were signifi cantly higher in patients with a poor response to therapy (p<0,05). Other clinical and laboratory parameters did not reach statistical signifi cance. Both responders and non-responders developed anaemia. A decrease in thrombocytes, neutrophils and white blood cells was signifi cantly associated with a sustained response to therapy (p<0,05, p<0,05 and p<0,001, respectively).Sustained virological response was associated with lower baseline AST and ALT values and thrombocytopenia, leucopenia and neutropenia at the end of the treatment. All treated patients developed anaemia.