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Dynamics of apoptotic activity during antiviral treatment of patients with chronic hepatitis C
Bernd Kronenberger1, Stefan Zeuzem, Christoph Sarrazin
1Medizinische Klinik I, Klinikum der Johann Wolfgang Goethe-UniversitRt, Frankfurt/Main, Germany.
Introduction:
Cell death during antiviral therapy of patients with chronic hepatitis C is not well understood.
Methods:
In the present study, apoptotic activity was monitored by quantification of apoptotic cytokeratin-18 neoepitopes in serum from patients with chronic hepatitis C before and 4, 12, 24 and 48 weeks after initiation of antiviral therapy with pegylated interferon-alpha2a and ribavirin and was compared with viral kinetic parameters.
Results:
After 4 weeks of treatment apoptotic activity decreased significantly compared with baseline. Later during treatment, however, apoptotic activity increased again to levels similar to baseline. Alanine aminotransferase (ALT) activity also showed a significant decrease at week 4 compared with baseline but, in contrast to apoptotic activity, ALT remained at a reduced level during the treatment period. Baseline apoptotic activity was inversely correlated with the infected cell loss while an increase of apoptotic activity within the first 4 treatment weeks compared with baseline was positively correlated with the infected cell loss.
Conclusions:
Apoptosis appears to be an important form of cell death during interferon-alpha-based treatment and is associated with infected cell loss and underestimated by ALT activity.
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