MxA expression as marker for assessing the therapeutic response in HCV genotype 4 Egyptian patients

The prevalence of hepatitis C virus (HCV) infection varies across the world, with the highest number of infections reported in Egypt. Expression of the MxA gene has been found to be a reliable and sensitive marker for the induction of endogenous type I interferons (IFNs) during viral infections. This study examined the correlation of gene expression of MxA with the response to treatment with pegylated-IFN-alfa2b and ribavirin. Fifty patients with type 4 HCV and 20 healthy volunteers as controls were enrolled in a prospective study designed with strict inclusion criteria to nullify the effect of confounding variables and further minimize selection bias. Quantification of HCV-RNA and MxA gene by real-time PCR was performed for every patient, and quantification of MxA gene was performed for controls. There was a statistically significant difference between patients and control group as regards the quantity of MxA gene expression (P < 0.05) (Mann-Whitney test) (P = 0.004). There was a statistically significant difference between responders and nonresponders (P < 0.05): responders showed a higher percentage of cases with initial MxA <2(6) (P < 0.05). We conclude that MxA protein expression is a sensitive biological marker for ongoing virus replication and presence of type 1 IFN. These results highlight the importance of the detection of MxA expression at the start of therapy as a factor for assessing the likelihood of HCV genotype 4 patients to achieving a sustained virological response to treatment with IFN-α2 in combination with ribavirin.