B-type natriuretic peptide (BNP) in HCV-positive Egyptian patients: the impact of HCV eradication on plasma BNP levels

Abstract Background Chronic hepatitis C virus (HCV) infection represents a major health-related burden in Egypt. HCV is considered as a major cardiovascular risk factor. BNP (B-type natriuretic peptide) has been determined as a credible diagnostic and prognostic cardiac biomarker. We aimed to assess plasma BNP in HCV-positive Egyptian patients prior and after HCV eradication by direct-acting antiviral agents (DAAs) therapy. Eighty-nine chronic HCV-positive patients were enrolled in our prospective research. They were provided with DAAs therapy in the form of sofosbuvir and daclatasvir without or with ribavirin for 12 weeks. History, clinical evaluation, and laboratory assessment: CBC, liver and kidney function tests, viral markers (HCVAb, HBVsAg, and HIVAb) by ELISA, HCV RNA by real-time PCR, and BNP by ELISA were assessed. FIB-4 and aspartate aminotransferase-to-platelet ratio index (APRI) scores were ranked. Results Plasma BNP displayed a non-significant (p = 0.124) increase of its serum mean values in post eradication of HCV than its baseline values. Baseline BNP exhibited a significant positive correlation with FIB4 (r = 0.411, P < 0.001) and APRI score (r = 0.418, p < 0.001) with a considerably negative correlation with platelets (r = − 0.274, p = 0.009), in addition to higher pretreatment BNP values in cirrhotic than in non-cirrhotic patients (p < 0.001), while non-significant relations were found regarding sex, BMI, and drug regimen (with or without ribavirin) (p = 0.950, 0.845, and 0.738, respectively). Additionally, plasma BNP values considerably decreased post-treatment in patients presented with higher baseline BNP values and more advanced liver disease (higher FIB4, APRI, and the presence of liver cirrhosis). Conclusion Our findings propose on the one side, the necessity of cardiac monitoring during chronic HCV infection and, on the other, the valuable impacts of HCV eradication on HCV-associated cardiac morbidities.

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Effect of Direct Acting Anti-Viral Drugs on Insulin Resistance and sensitivity Among Egyptian Chronic HCV Infected Patients

QJM ◽

10.1093/qjmed/hcab100.111 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Tareq M Yosef ◽

Wesam A Ibrahim ◽

Sarah A El-Nakeep ◽

Ahmed M ElGhandour ◽

Soha saied attiya

Keyword(s):

Insulin Resistance ◽

Fasting Blood Glucose ◽

Hcv Infection ◽

Military Hospital ◽

Hcv Rna ◽

Matsuda Index ◽

Treatment Naïve ◽

Chronic Hcv ◽

Direct Acting ◽

The Impact

Abstract Background Hepatitis C virus (HCV) infection is a worldwide infection, affecting up to 185 million people across the world. It carries a high risk for developing liver cirrhosis, hepatocellular carcinoma (HCC) and liver-related deaths. Aim of the Work to assess the impact of direct acting anti-viral drugs on the status of insulin resistance and sensitivity in non-diabetic chronic HCV infection patients Patients and Methods study included 100 treatment naive patients with chronic infection of HCV attending the out-patient clinic at Gastro-enterology and Hepatology Department, Ain shams University and Kobry El Kobba Military Hospital between September 2017 till June 2019. Patients were diagnosed by HCV antibodies & HCV RNA by PCR. Results The fasting blood glucose, seum insulin and HbA1c were significantly decreased between the baseline and after SVR12. The 2Hrs PP was significantly increased between the baseline and after SVR12. The HOMA-IR showed significant decrease between the baseline and SVR12. The QUICKI and Matsuda Index showed significant increase at SVR12. Conclusion HOMA-IR, QUICKI and Matsuda index showed significant improvement between the baseline and after SVR12.

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Impact of Interleukin 28B and ICAM-1 Genetic Polymorphisms on Response to Direct Antiviral Treatment Among HCV Infected Patients

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200505113619 ◽

2020 ◽

Vol 20 (8) ◽

pp. 1328-1335 ◽

Cited By ~ 1

Author(s):

Amel G. Elsheredy ◽

Abdulrahman H. Almaeen ◽

Amany A. Ghazy ◽

Ghada F. Helaly ◽

Ibrahim Amer ◽

...

Keyword(s):

Antiviral Treatment ◽

Antiviral Agents ◽

Response To Treatment ◽

Hcv Rna ◽

Nucleotide Polymorphisms ◽

Allelic Discrimination ◽

Liver Function Testing ◽

Egyptian Patients ◽

Hcv Genotyping ◽

The Impact

Background: Single nucleotide polymorphisms (SNPs) of IL-28B and/or ICAM-1 could have a role in expecting a response from HCV infected patients to direct antiviral agents (DAAs). Objective: The aim of the current study was to investigate the impact of IL-28B rs12979860 and rs8099917, and, ICAM-1 rs281437 SNPs on response to treatment with sofosbuvir + Daclatsvir ± Ribavirin, among HCV-infected Egyptian patients. Methods: Whole blood genomic DNA was extracted from 120 participants (80 HCV-infected patients and 40 healthy volunteers). HCV-infected patients were subdivided into responders and nonresponders to DAAs. Liver function testing, anti-HCV antibodies, HCV-RNA viral load and HCV genotyping were performed. IL-28B and ICAM-1 SNPs were evaluated by real-time PCR. Results: ALT and AST levels were significantly higher among non-responder HCV infected patients (P = 0.001*). 90% of the patients had HCV genotype 4a and the remaining 10% had 4l genotype. Allelic discrimination revealed that IL-28B rs12979860 T, IL-28B rs809917 T and ICAM-1 rs281437 C alleles were more frequent among HCV-infected patients (responders or non-responders) than controls. However, IL-28B rs8099917 G allele was more frequent among healthy controls. Regarding the response to DAAs treatment, HCV-infected patients with IL-28B rs8099917 GG genotype showed a significantly earlier viral response compared to those carrying TT alleles. ICAM-1 rs281437 CT alleles were non significantly more frequent among responders. However, IL-28B rs12979860 alleles did not show any difference. Conclusion: Genotyping of IL-28B rs8099917 is a useful independent tool for expecting a response of Egyptian HCV-infected patients to DAAs.

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Recurrence of Cryoglobulinemia Secondary to Hepatitis C in a Patient with HCV RNA (−) Negative in the Serum

Case Reports in Nephrology and Dialysis ◽

10.1159/000515587 ◽

2021 ◽

pp. 110-115

Author(s):

Małgorzata Sikorska-Wiśniewska ◽

Katarzyna Sikorska ◽

Anna Wróblewska ◽

Tomasz Liberek ◽

Agnieszka Perkowska-Ptasińska ◽

...

Keyword(s):

Hepatitis C ◽

Mononuclear Cells ◽

Antiviral Treatment ◽

Antiviral Agents ◽

Mixed Cryoglobulinemia ◽

Virologic Response ◽

Hcv Infection ◽

Hcv Rna ◽

Peripheral Blood Mononuclear ◽

The Impact

Hepatitis C virus infection is associated with many extrahepatic manifestations such as mixed cryoglobulinemia (MC). Renal manifestation of HCV infection might present as cryo-positive membranoproliferative glomerulonephritis (MPGN). First-line therapy includes antiviral treatment as the underlying infection leads to formation of immune complexes. After introducing direct-acting antiviral agents (DAAs) cure rates of HCV infection increased. Sustained virologic response (SVR) is defined as the absence of HCV RNA in serum by a sensitive test performed 12 or 24 weeks after the end of antiviral treatment. Although HCV RNA is undetectable in the serum, it may be present in hepatocytes and peripheral blood mononuclear cells (occult HCV infection). However, the impact of DAA treatment on occult HCV infection is not clear. We report a case of recurrence of MC with MPGN and development of lymphoproliferative disorder 2 years after achieving SVR.

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Hepatitis C virus infection and risk of liver-related and non-liver-related deaths: a population-based cohort study in Naples, southern Italy

BMC Infectious Diseases ◽

10.1186/s12879-021-06336-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pierluca Piselli ◽

Diego Serraino ◽

Mario Fusco ◽

Enrico Girardi ◽

Angelo Pirozzi ◽

...

Keyword(s):

Southern Italy ◽

Population Based ◽

Hcv Infection ◽

Hcv Rna ◽

Risk Of Death ◽

High Prevalence ◽

Specific Mortality ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Related Mortality

Abstract Background Hepatitis C virus (HCV) infection represents a global health issue with severe implications on morbidity and mortality. This study aimed to evaluate the impact of HCV infection on all-cause, liver-related, and non-liver-related mortality in a population living in an area with a high prevalence of HCV infection before the advent of Direct-Acting Antiviral (DAA) therapies, and to identify factors associated with cause-specific mortality among HCV-infected individuals. Methods We conducted a cohort study on 4492 individuals enrolled between 2003 and 2006 in a population-based seroprevalence survey on viral hepatitis infections in the province of Naples, southern Italy. Study participants provided serum for antibodies to HCV (anti-HCV) and HCV RNA testing. Information on vital status to December 2017 and cause of death were retrieved through record-linkage with the mortality database. Hazard ratios (HRs) for cause-specific mortality and 95% confidence intervals (CIs) were estimated using Fine-Grey regression models. Results Out of 626 deceased people, 20 (3.2%) died from non-natural causes, 56 (8.9%) from liver-related conditions, 550 (87.9%) from non-liver-related causes. Anti-HCV positive people were at higher risk of death from all causes (HR = 1.38, 95% CI: 1.12–1.70) and liver-related causes (HR = 5.90, 95% CI: 3.00–11.59) than anti-HCV negative ones. Individuals with chronic HCV infection reported an elevated risk of death due to liver-related conditions (HR = 6.61, 95% CI: 3.29–13.27) and to any cause (HR = 1.51, 95% CI: 1.18–1.94). The death risk of anti-HCV seropositive people with negative HCV RNA was similar to that of anti-HCV seronegative ones. Among anti-HCV positive people, liver-related mortality was associated with a high FIB-4 index score (HR = 39.96, 95% CI: 4.73–337.54). Conclusions These findings show the detrimental impact of HCV infection on all-cause mortality and, particularly, liver-related mortality. This effect emerged among individuals with chronic infection while those with cleared infection had the same risk of uninfected ones. These results underline the need to identify through screening all people with chronic HCV infection notably in areas with a high prevalence of HCV infection, and promptly provide them with DAAs treatment to achieve progressive HCV elimination and reduce HCV-related mortality.

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Demonstration and Distribution of HCV RNA Sequences by in situ Hybridization and HCV-Related Proteins by Immunohistochemistry in the Liver Tissue of Patients with Chronic HCV Infection

Pathobiology ◽

10.1159/000163956 ◽

1995 ◽

Vol 63 (5) ◽

pp. 239-248 ◽

Cited By ~ 10

Author(s):

Domenico Sansonno ◽

Vito Cornacchiulo ◽

Anna Rina Iacobelli ◽

Pietro Gatti ◽

Maria Di Stasi ◽

...

Keyword(s):

In Situ Hybridization ◽

Liver Tissue ◽

Hcv Infection ◽

Hcv Rna ◽

Rna Sequences ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Related Proteins

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P1652IMPACT OF HEPATITIS C VIRUS AND DIRECT ACTING ANTIVIRALS ON JAPANESE RENAL ALLOGRAFT RECIPIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1652 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Kazuaki Okino ◽

Keita Yamazaki ◽

Keiichiro Okada ◽

Keiji Fujimoto ◽

HIROKI ADACHI ◽

...

Keyword(s):

Renal Transplantation ◽

Renal Allograft ◽

Patient Survival ◽

Hcv Infection ◽

Hcv Rna ◽

Direct Acting Antivirals ◽

Group A ◽

Group B ◽

Direct Acting ◽

The Impact

Abstract Background and Aims The impact of hepatitis C virus (HCV) infection on patient survival after renal transplantation was worse. Previously, we found that continuous HCV infection was a significant independent risk factor for actuarial survival (especially at ≥20 years after the transplant procedure) among Japanese renal allograft recipients. This study evaluates the impact of HCV and of the new direct acting antivirals (DAAs) on patient outcomes in renal allograft recipients. Method We studied 46 cases (28 males, 18 females; 37 living-donor cases, 9 deceased-donor cases; mean follow-up period 305 months ranging from 2 to 420 months) out of the 315 renal transplanted patients who underwent the first renal transplantation in Kanazawa Medical University since 1974. They had antibodies against HCV: 11 were positive for HCV RNA and received DAAs (Group A, all of them genotype 1b); 27 were HCV RNA positive and did not receive any treatment (Group B); 8 were negative for HCV RNA (Group C) (Fig.1). Results All Group A patients had HCV RNA negativity after 2-12 weeks of treatment started, and 11 (100%) achieved a sustained virological response (SVR) at 24 weeks. All of them had no adverse effects by the use of DAAs. In this cohort, no patients in Group A died. On the other hand, 15 (55.5％) of 27 in Group B and 3 (37.5%) of 8 in Group C died. Causes of death among Group B were liver cirrhosis (5 cases), hepatocellular carcinoma (2 case), infections complicated with chronic hepatitis (6 cases) in chronic phase, fibrosing cholestatic hepatitis due to HCV (1 case) after surgery, and cardiovascular disease (1 case). The patient survival rate was significantly higher in Group A patients who received DAAs by Kaplan- Meier life table method (Log Rank test, Kay-square 11.7, p=0.004) (Fig.2). Conclusion Our results support the notion that continuous HCV infection was a harmful and that new DAAs were efficient and safe to treat HCV infection after renal transplantation.

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Virus Elimination by Direct-Acting Antiviral Agents Impacts Glucose Homeostasis in Chronic Hepatitis C Patients

Frontiers in Endocrinology ◽

10.3389/fendo.2021.799382 ◽

2022 ◽

Vol 12 ◽

Author(s):

Chun-Han Cheng ◽

Chia-Ying Chu ◽

Huan-Lin Chen ◽

I-Tsung Lin ◽

Chia-Hsien Wu ◽

...

Keyword(s):

Glucose Homeostasis ◽

Antiviral Agents ◽

Hcv Infection ◽

Treatment Experience ◽

Factors Associated ◽

Direct Acting Antiviral ◽

Chronic Hcv Infection ◽

Hcv Genotype 1 ◽

Chronic Hcv ◽

Direct Acting

Background and AimsChronic hepatitis C virus (HCV) infection is associated with dysregulation of glucose homeostasis, including insulin resistance (IR) and type 2 diabetes. However, independent risk factors associated with IR in chronic HCV-infected patients have not been detailly elucidated. Previous data regarding the impact of HCV elimination by direct-acting antiviral agents (DAAs) on glucose homeostasis is insufficient and controversial. This study aimed to analyze the independent factors associated with IR and to evaluate the changes in glucose homeostasis in chronic HCV-infected patients treated with DAAs therapies.MethodsWe screened 704 patients with chronic HCV infection who underwent treatment with interferon-free DAAs. Patients’ baseline characteristics, biochemical and virological data were collected. The outcome measurements were their IR and β-cell function assessed by the homeostasis model assessment (HOMA) method at baseline and 12-weeks post-treatment.ResultsHigh IR (HOMA-IR ≥ 2.5) was observed in 35.1% of the patients. Multivariable logistic regression analysis revealed that body mass index (BMI) >25 kg/m2, treatment experience, elevated baseline levels of alanine aminotransferase (ALT) and triglyceride, as well as Fibrosis-4 score >3.25 were independently associated with high IR. In patients who achieved sustained virological response (SVR), no significant change in mean HOMA-IR was observed from baseline to 12-weeks post-treatment (2.74 ± 2.78 to 2.54 ± 2.20, p = 0.128). We observed a significant improvement in β-cell secretion stress from 121.0 ± 110.1 to 107.6 ± 93.0 (p = 0.015). Subgroup analysis revealed that SVR was associated with a significant reduction in mean HOMA-IR in patients with baseline HOMA-IR ≥ 2.5 (5.31 ± 3.39 to 3.68 ± 2.57, p < 0.001), HCV genotype 1 (3.05 ± 3.11 to 2.62 ± 2.05, p = 0.027), and treatment experience (4.00 ± 3.37 to 3.01 ± 2.49, p = 0.039).ConclusionsThere were several independent factors associated with IR in patients with chronic HCV infection, including obesity, treatment experience, high serum ALT and triglyceride levels, as well as advanced hepatic fibrosis. After viral elimination by DAAs, we observed a significant reduction in mean HOMA-IR in patients with baseline high IR, HCV genotype 1, and treatment experience.

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French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

BMC Infectious Diseases ◽

10.1186/s12879-020-05478-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cécile Brouard ◽

Josiane Pillonel ◽

Marjorie Boussac ◽

Victor de Lédinghen ◽

Antoine Rachas ◽

...

Keyword(s):

Hepatitis C ◽

Antiviral Treatment ◽

Hcv Infection ◽

World Health ◽

Direct Acting Antivirals ◽

Substantial Impact ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Direct Acting ◽

The Impact

Abstract Background Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs). Methods The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System. Results Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7 to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016). Conclusions This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.

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HCV Core Antigen as an alternative test to Quantitative HCV RNA for assessment of SVR in Chronic HCV infected patients treated with Direct Acting Antiviral agents

QJM ◽

10.1093/qjmed/hcaa052.025 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

S M Mohamed ◽

N I Musa ◽

R S Ghait ◽

B M Abdelrhiem

Keyword(s):

Antiviral Agents ◽

Virologic Response ◽

Hcv Infection ◽

Core Antigen ◽

Hcv Rna ◽

Viral Kinetics ◽

Direct Acting Antiviral ◽

Hcv Core Antigen ◽

End Of Treatment ◽

Direct Acting

Abstract Background and aims Widespread use of direct-acting antiviral (DAA) agents to treat patients with hepatitis C virus (HCV) infection has reduced the need for monitoring of HCV-RNA levels, because viral kinetics do not predict sustained virologic response (SVR) to these drugs. However, the performance of cheaper tests, such as the assay to quantify HCV core antigen (HCV Ag), has not been determined. This study was aimed at investigating the accuracy of the HCV Ag test in predicting which patients receiving DAAs will achieve SVR at week 12 (SVR12). Methods We performed a prospective study on 90 patients, chronically infected with HCV, receiving DAAs therapy from different NCCVH centers in Cairo during the period from August 2017 to June 2018. We collected blood samples and measured the levels of HCV core Ag and HCV-RNA at baseline and 12 weeks after end of treatment. We compared the ability of these assays to predict which patients would have SVR12. Results The median baseline level of HCV-RNA was 1688529.6 ± 994697.3 IU/ml (range, 312700 IU/ml to 3491100 IU/ml) and HCV Ag was 179.2 ± 83.5 pg/ml (range, 33.5 pg/ml to 315.6 pg/ml). HCV Ag became undetectable in 92.2% 12 weeks after the end of treatment. HCV-RNA became undetectable in 87.8% at the end of treatment (P<.0001). 79 out of 90 patients (87.8%) achieved an SVR12; the test for HCV Ag identified 63.6% of these patients. Conclusions Tests that measure HCV Ag monitor efficacy of DAA therapy for HCV infection as well as assays that measure HCV-RNA, and hence could be recommended for clinical practice.

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Body mass index (BMI) and alpha-fetoprotein (AFP) level correlate with the severity of HCV-induced fibrosis in a cohort of Egyptian patients with chronic HCV

Future Journal of Pharmaceutical Sciences ◽

10.1186/s43094-020-00085-3 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Amal Ahmed Mohamed ◽

Amr Ali Hemeda ◽

Ramy Karam Aziz ◽

Mohamed Salaheldin Abdel-Hakeem ◽

Marwa Ali-Tammam

Keyword(s):

Body Mass Index ◽

Hepatitis C ◽

Liver Fibrosis ◽

Body Mass ◽

Alpha Fetoprotein ◽

Hcv Infection ◽

Hcv Genotype ◽

Egyptian Patients ◽

Chronic Hcv ◽

Severe Fibrosis

Abstract Background Viral hepatitis is the seventh leading cause of mortality globally, and half of this mortality is attributed to hepatitis C virus (HCV). Egypt has the highest HCV prevalence worldwide, with an estimated 14.7% of the population being HCV-positive. HCV infection is the primary cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Liver fibrosis varies in severity during chronic HCV infection, and 10–20% of chronic hepatitis C (CHC) patients with severe fibrosis develop cirrhosis. The goal of this work was to assess the clinico-demographic predictors of severity of HCV-induced fibrosis in a cohort of Egyptian patients. Results A cohort of Egyptian patients with chronic HCV genotype 4a infection showed significant association between severe fibrosis stages and obesity, represented by a higher body mass index (BMI), low albumin level, high alpha-fetoprotein (AFP) level, low thyroid-stimulating hormone (TSH) level, and high alkaline phosphatase (ALP) level. Multivariate analysis delineated BMI, TSH, and ALP as independent significant variables that could predict the risk of fibrosis severity in HCV infections. Conclusion This study argues in favor of using the biomarker profile of CHC patients infected with HCV genotype 4a to identify patients at higher risk of developing severe fibrosis, which is a necessary first step towards precision medicine via patient stratification.

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