Herpes Zoster reactivation in patients with chronic hepatitis C under treatment with directly acting antiviral agents: A case series

Kassas, Mohamed El; Wifi, Mohamed Naguib; Mahdy, Reem Ezzat; Afify, Shimaa; Hafez, E. S. E.; Latif, Yasmeen Abd El; Ezzat, Marwa; Tahan, Adel El; Youssef, Naglaa; Esmat, Gamal

doi:10.1016/j.ajg.2017.02.003

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…Most of cytokine/chemokine responses appeared to be indicating a return to immune homeostasis and may lead to prevention of HCC in the long term. Nevertheless, unexpected higher rates of the occurrence and recurrence of HCC were observed during and immediately following DAA treatment, and reactivation of opportunistic viruses after DAA treatment have been reported . Follow‐up of these DAA‐treated patients for a longer period should help in further determining treatment outcome.…”

Section: Discussioncontrasting

confidence: 84%

Rapid hepatitis C virus clearance by antivirals correlates with immune status of infected patients

Sasaki

Meyer

Moriyama

et al. 2018

Journal of Medical Virology

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Altered immune parameters associated with hepatitis C virus (HCV) genotype 1b infection and their correlation with virus eradication in direct-acting antivirals (DAA)-treated patients were examined. Thirty-one HCV-infected patients were treated with DAAs for 12 weeks. Pre-DAA-treatment and post-DAA-treatment sera were analyzed for cytokines/chemokines using MILLIPLEX MAP. Serum complement level and antibody neutralization activity were measured separately. Sera from 11 spontaneously cleared HCV subjects were included for comparison. Rapid virological responders (RVR) or end-of-treatment responders (EOTR) were defined as patients with HCV RNA negative at week 4 or positive at week 4 and negative at week 12, respectively. HCV RNA eradication and a decrease in liver fibrosis-related cytokines after treatment were observed when compared with pretreatment sera from RVR and EOTR. In pretreatment sera, interferons and T-helper 1 or 2 cell-associated cytokines/chemokines were significantly higher among RVR as compared with EOTR. Furthermore, serum complement and virus neutralizing antibody levels were higher in pretreatment RVR sera. Eradication of HCV RNA by DAA decreased liver fibrosis-related cytokines. Pretreatment sera from RVR displayed an enhanced cytokine/chemokine, complement and virus neutralizing antibody response as compared with EOTR sera. Our results suggested that enhanced host immune status may play an additive role on HCV RNA clearance by DAA.

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Section: Discussioncontrasting

confidence: 84%

Rapid hepatitis C virus clearance by antivirals correlates with immune status of infected patients

Sasaki

Meyer

Moriyama

et al. 2018

Journal of Medical Virology

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“…Suppressive effect of HCV infection on HZ that is removed after treatment by DAAs could be assumed as the main reason for HZ reactivation or may be a possible direct role of DAAs as a part of immune system restoration 10. Another explanation may be immune reconstitution inflammatory syndrome (IRIS), which can be seen in some HIV-infected patients after highly active antiretroviral therapy.…”

Section: Discussionmentioning

confidence: 99%

<p>Reactivation of herpesvirus in patients with hepatitis C treated with direct-acting antiviral agents</p>

Ghweil

Helal

2019

IDR

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Background We performed a case-series analysis of reactivation of herpesvirus in patients with hepatitis C virus (HCV) infection treated with direct-acting antiviral (DAA) agents. Methods Eight cases were detected among 100 treated patients with DAA regimens in Qena University Hospital from June 2016 to June 2017. Herpesvirus was reactivated in eight patients who received DAA therapy. None of the cases had risk factor for herpes zoster reactivation. Results The DAA regimens used were sofosbuvir/daclatasvir in six cases and sofosbuvir/ledipasvir in two cases. Immune changes that follow HCV clearance might lead to reactivation of other viruses, such as herpesvirus. Conclusion Patients with HCV infection suspected of having herpesvirus infection should be treated promptly.

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“…Due to an unbalanced immunity after SVR, HCV elimination poses some concerns regarding reactivation of latent coinfections, such as HBV (96) or herpesvirus (97,98), or the development of HCC (82)(83)(84). For instance, despite reducing inflammation, an increase in angiogenesis-related gene expression, which may favor HCC development, has been observed in cured patients (81,99).…”

Section: Final Remarksmentioning

confidence: 99%

HCV Cure With Direct-Acting Antivirals Improves Liver and Immunological Markers in HIV/HCV-Coinfected Patients

et al. 2021

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Hepatitis C virus (HCV) cure after all-oral direct-acting antiviral (DAA) therapy greatly improves the liver and immune system. We aimed to assess the impact of this HCV clearance on immune system-related markers in plasma and the gene expression profile in human immunodeficiency virus (HIV)/HCV-coinfected patients with advanced cirrhosis. We performed a prospective study on 33 HIV/HCV-coinfected patients at baseline and 36 weeks after the sustained virological response. Gene expression was evaluated by RNA-seq analysis on peripheral blood mononuclear cells (PBMCs) and plasma biomarkers by multiplex immunoassays. We found a decrease in plasma biomarkers (PD1, PDL1, CXCL10, CXCL8, IL12p70, IL10, and TGFβ) and liver disease markers (stiffness measurement (LSM), hepatic venous pressure gradient (HVPG), and transaminases, among others). Furthermore, decreased plasma levels of CXCL8, CXCL10, IL10, and PD1 were associated with reduced LSM values. We also found two upregulated (HAS1 and IRG1) and 15 downregulated (CXCL11, CCL8, CCL7, CCL2, ADARB2, RRAD, MX1, SIGLEC1, IFI44L, IFI44, IFI27, IFI6, IFIT3, IFIT1B, and IFIT1) genes at the end of follow-up, all interferon-stimulated genes (ISGs) grouped into four pathways (“cytokine-cytokine receptor interaction”, “viral protein interaction with cytokine and cytokine receptor”, “chemokine signaling pathway”, and “hepatitis C”). Additionally, the decrease in most of these ISGs was significantly related to reduced LSM and HVPG values. In conclusion, HIV/HCV-coinfected patients with advanced-HCV-related cirrhosis who eradicated HCV following DAA therapy exhibited an improvement in liver disease markers and a significant decrease in plasma biomarkers and gene expression related to antiviral/inflammatory response, particularly in levels of several chemokines and ISGs.

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Herpes Zoster reactivation in patients with chronic hepatitis C under treatment with directly acting antiviral agents: A case series

Cited by 10 publications

References 9 publications

Rapid hepatitis C virus clearance by antivirals correlates with immune status of infected patients

Rapid hepatitis C virus clearance by antivirals correlates with immune status of infected patients

<p>Reactivation of herpesvirus in patients with hepatitis C treated with direct-acting antiviral agents</p>

HCV Cure With Direct-Acting Antivirals Improves Liver and Immunological Markers in HIV/HCV-Coinfected Patients

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