Serological and salivary markers compared with biochemical markers for monitoring interferon treatment for hepatitis C virus infection

Abstract

Paired serum and saliva specimens were collected on a regular basis from 18 asymptomatic blood donors participating in a controlled clinical trial of interferon alpha 2a (IFN) treatment of chronic hepatitis C virus (HCV) infection. Nine patients were randomised to receive interferon and nine to observation only. Serum and salivary HCV RNA was detected by a "nested" polymerase chain reaction (PCR) assay. Complete follow-up data were available for 14 patients (7 treated and 7 untreated). Serum ALT levels declined to normal in five of the seven IFN-treated patients by the twelfth week. Of these five, loss of hepatitis C viraemia was observed in three. Of the seven treated patients, the three responders had a lower viraemia level than the partial or nonresponders. Both nonresponders had infection with type 1 HCV, but the complete and partial responders were infected with types 2 or 3. HCV RNA was detected in the saliva of all seven observation patients during the follow-up period. HCV was also detected in the saliva of the two patients who did not respond to IFN treatment. No correlation was shown between the level of HCV RNA in serum and the presence of HCV RNA in saliva. A role for noninvasive salivary investigations in monitoring treatment is possible, but further refinement of the methodology is required.

HCV clearance patterns in saliva and serum of patients with chronic HCV infection under interferon plus ribavirin therapy

“…In a paper by Roy et al. (6) HCV‐RNA clearance was detected in the saliva of two treated patients who did not respond to IFN, which corresponds with our pattern 3b. Nevertheless, patterns 3a and 3b are contradictory, and could not be justified with this argument.…”

“…It has been suggested that monitoring the effect of IFN by evaluating HCV‐RNA in saliva has not shown a direct relationship with HCV in blood (6). In agreement with these authors, the description of three different HCV clearance patterns in saliva of patients with chronic HCV infection under interferon plus ribavirin therapy has been made.…”

“…In 1995, Roy et al. (6) studied saliva samples from HCV‐positive patients under interferon (IFN) α ‐2a, suggesting that the role of salivary investigations in monitoring antiviral treatment was promising. Nowadays, IFN α ‐2b plus ribavirin regimen represent a first‐line treatment for patients with chronic hepatitis C (7).…”

Predominance of HCV type 2a in saliva from intravenous drug users

“…RNA was extracted from 200 l of serum and saliva using the QIAamp blood kit (QIAGEN, Surrey, UK) according to the manufacturer's instructions, with the addition of carrier RNA (1 g/ml) (GIBCO-BRL, Life Technologies, Paisley, Scotland) and 1 unit of RNA guard (Pharmacia, Herts, UK). Reverse transcription and PCR using primers derived from the 5Ј non-coding region (NCR) was carried out as previously described [Roy et al, 1995]. Briefly, synthesis of cDNA from 10 l RNA was carried out at 37°C for 30 min with 200 units of Moloney Murine Leukaemia Virus (MMLV) reverse transcriptase (GIBCO-BRL) in 20 l buffer containing 50 mM KCl, 2.5 mM MgCl 2 , 20 mM Tris-HCl pH 8.4, 0.1 mM (each) dNTP and 1 unit of RNA guard (Pharmacia).…”

Detection of hepatitis C virus RNA in saliva samples from patients with seric anti-HCV antibodies

“…The various studies that have compared viral load with the presence of HCV-RNA in the saliva have shown both positive [9,15,23,27] and negative correlations [10,28]. We did not evaluate this association.…”