Long-term follow-up of patients with chronic HCV infection and compensated or decompensated cirrhosis following treatment with sofosbuvir-based regimens

The aim of the study was to elucidate the epidemiological features of Hepatitis C virus (HCV) infection among teenagers in an endemic area by conducting a mass screening study. We also investigated the clinical outcome of the anti-HCV-positive subjects by conducting subsequent short-term and long-term follow-up studies. All 2837 students of two junior middle schools in Tzukuan, aged 13–16 years, were invited to be screened for anti-HCV, HBsAg, AST and ALT in October 1995. A total of 2726 (96%) students responded. Anti-HCV, HCV RNA and aminotransferase levels were evaluated among anti-HCV-positive students 1 month and 30 months later, respectively. A total of 38 (1·4%; M/F = 22/16) participants were anti-HCV-positive. The anti-HCV-positive students had higher rates of exposures to transfusion, anti-HCV-positive families and surgery. The prevalence (2·8%) of the 7 maritime villages was markedly higher than that (0·7%) of the other 8 villages (P < 0·001). Subsequent follow-up studies demonstrated that there might be 5 cases of acute or recent HCV infection, and 6 cases who had recovered from chronic HCV infection.

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Antigenic cooperation among intrahost HCV variants organized into a complex network of cross-immunoreactivity

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1422942112 ◽

2015 ◽

Vol 112 (21) ◽

pp. 6653-6658 ◽

Cited By ~ 22

Author(s):

Pavel Skums ◽

Leonid Bunimovich ◽

Yury Khudyakov

Keyword(s):

Immune Escape ◽

Complex Dynamics ◽

Viral Evolution ◽

Hcv Infection ◽

Viral Population ◽

Viral Adaptation ◽

Chronic Hcv Infection ◽

Potential Strategy ◽

Chronic Hcv

Hepatitis C virus (HCV) has the propensity to cause chronic infection. Continuous immune escape has been proposed as a mechanism of intrahost viral evolution contributing to HCV persistence. Although the pronounced genetic diversity of intrahost HCV populations supports this hypothesis, recent observations of long-term persistence of individual HCV variants, negative selection increase, and complex dynamics of viral subpopulations during infection as well as broad cross-immunoreactivity (CR) among variants are inconsistent with the immune-escape hypothesis. Here, we present a mathematical model of intrahost viral population dynamics under the condition of a complex CR network (CRN) of viral variants and examine the contribution of CR to establishing persistent HCV infection. The model suggests a mechanism of viral adaptation by antigenic cooperation (AC), with immune responses against one variant protecting other variants. AC reduces the capacity of the host’s immune system to neutralize certain viral variants. CRN structure determines specific roles for each viral variant in host adaptation, with variants eliciting broad-CR antibodies facilitating persistence of other variants immunoreacting with these antibodies. The proposed mechanism is supported by empirical observations of intrahost HCV evolution. Interference with AC is a potential strategy for interruption and prevention of chronic HCV infection.

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Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2017/4381864 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8

Author(s):

Mamatha Bhat ◽

Kathleen C. Rollet-Kurhajec ◽

Aparna Bhat ◽

Amanda Farag ◽

Marc Deschenes ◽

...

Keyword(s):

Liver Fibrosis ◽

Liver Transplant ◽

Hcv Infection ◽

Serum Biomarker ◽

Advanced Fibrosis ◽

Advanced Liver Fibrosis ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Liver Transplant Recipients

Background and Aims. Serum fibrosis biomarkers have shown good accuracy in the liver transplant (LT) population. We employed a simple serum biomarker to elucidate incidence and predictors of advanced fibrosis after LT over a long follow-up period.Methods. We included 440 consecutive patients who underwent LT between 1991 and 2013. Advanced liver fibrosis was defined as FIB-4 > 3.25 beyond 12 months after LT.Results. Over 2030.5 person-years (PY) of follow-up, 189 (43%) developed FIB-4 > 3.25, accounting for an incidence of 9.3/100 PY (95% confidence interval [CI], 8.1–10.7). Advanced fibrosis was predicted by chronic HCV infection (adjusted hazard ratio (aHR) = 3.96, 95% CI 2.92–5.36,p< 0.001), hypoalbuminemia (aHR = 2.31, 95% CI 1.72–3.09;p< 0.001), and hyponatremia (aHR = 1.48, 95% CI 1.09–2.01;p= 0.01). LT recipients with more than 1 predictor had a higher incidence of advanced fibrosis, the highest being when all 3 predictors coexisted (log-rank:p< 0.001).Conclusions. Chronic HCV infection, hypoalbuminemia, and hyponatremia predict progression to advanced liver fibrosis following LT. Patients with these risk factors should be serially monitored using noninvasive fibrosis biomarkers and prioritized for interventions.

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