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Childs K, Merritt E, Considine A, et al. Immunological Predictors of Nonresponse to Directly Acting Antiviral Therapy in Patients With Chronic Hepatitis C and Decompensated Cirrhosis. Open Forum Infect Dis. 2017;4(2):ofx067doi: 10.1093/ofid/ofx067.
Childs, K., Merritt, E., Considine, A., Sanchez-Fueyo, A., Agarwal, K., Martinez-Llordella, M., & Carey, I. (2017). Immunological Predictors of Nonresponse to Directly Acting Antiviral Therapy in Patients With Chronic Hepatitis C and Decompensated Cirrhosis. Open forum infectious diseases, 4(2), ofx067. https://doi.org/10.1093/ofid/ofx067
Childs, Kate, et al. "Immunological Predictors of Nonresponse to Directly Acting Antiviral Therapy in Patients With Chronic Hepatitis C and Decompensated Cirrhosis." Open forum infectious diseases vol. 4,2 (2017): ofx067. doi: https://doi.org/10.1093/ofid/ofx067
Childs K, Merritt E, Considine A, Sanchez-Fueyo A, Agarwal K, Martinez-Llordella M, Carey I. Immunological Predictors of Nonresponse to Directly Acting Antiviral Therapy in Patients With Chronic Hepatitis C and Decompensated Cirrhosis. Open Forum Infect Dis. 2017 Apr 03;4(2):ofx067. doi: 10.1093/ofid/ofx067. eCollection 2017. PMID: 28584852; PMCID: PMC5450903.
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Open Forum Infect Dis. 2017 Apr 03;4(2):ofx067. doi: 10.1093/ofid/ofx067. eCollection 2017.

Immunological Predictors of Nonresponse to Directly Acting Antiviral Therapy in Patients With Chronic Hepatitis C and Decompensated Cirrhosis.

Open forum infectious diseases

Kate Childs, Elliot Merritt, Aisling Considine, Alberto Sanchez-Fueyo, Kosh Agarwal, Marc Martinez-Llordella, Ivana Carey

Affiliations

  1. Liver Sciences, King's College London, United Kingdom; and.
  2. Institute of Liver Studies, King's College Hospital, London, United Kingdom.

PMID: 28584852 PMCID: PMC5450903 DOI: 10.1093/ofid/ofx067

Abstract

BACKGROUND: Sustained virological response rates (SVRs) to directly acting antiviral (DAA) therapy for hepatitis C virus (HCV) are lower in decompensated cirrhosis. Markers of innate immunity predict nonresponse to interferon-based HCV treatment; however, whether they are associated with the response to DAAs in patients with decompensation is not known.

METHODS: Information on demographics, adherence, viral kinetics, and resistance were gathered prospectively from a cohort with decompensated cirrhosis treated with 12 weeks of DAAs. C-X-C motif chemokine-10 (CXCL-10) level and T-cell and natural killer (NK) cell phenotype were analyzed pretreatment and at 4 and 12 weeks of treatment.

RESULTS: Of 32 patients, 24 of 32 (75%) achieved SVR (responders). Eight of 32 (25%) experienced relapse after the end of treatment (nonresponders). There were no differences in demographics or adherence between groups. Nonresponders had higher CXCL-10; 320 pg/mL (179461) vs 109 pg/mL (88170) in responders (

CONCLUSIONS: Nonresponders to DAAs displayed a different NK phenotype and CXCL-10 profile to responders. Nonresponders did not have poorer adherence or baseline virological resistance, and this shows that immunological parameters are associated with treatment response to interferon-free treatment for HCV in individuals with decompensated cirrhosis.

© The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Keywords: HCV; cirrhosis; directly acting antiviral; hepatitis C.

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