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Successful DAA therapy for chronic hepatitis C reduces HLA-DR on monocytes and circulating immune mediators: A

Natalia Fonseca Rosário1, Geórgia do Nascimento Saraiva1, Thalia Medeiros1

  • 1Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Faculdade de Medicina, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil.

Immunology Letters
|September 18, 2020
PubMed

Insights

Direct-acting antiviral (DAA) treatment for hepatitis C (HCV) eradicated the virus but did not alter monocyte subsets. Long-term, DAA therapy reduced monocyte activation and restored immune mediators, suggesting sustained inflammation reversal.

Area of Science:

  • Immunology
  • Hepatology
  • Virology

Background:

  • Hepatitis C Virus (HCV) infection leads to chronic inflammation.
  • Direct-acting antiviral (DAA) therapy achieves sustained virological response (SVR) but long-term immune effects are unclear.
  • Monocyte subsets and immune mediators may play a role in HCV pathogenesis and treatment response.

Purpose of the Study:

  • To investigate the long-term impact of IFN-free sofosbuvir-based DAA treatment on peripheral monocyte subsets and immune mediators in Brazilian chronic HCV patients.
  • To assess changes at sustained virological response (SVR) and one year after treatment completion (1y).

Main Methods:

  • Flow cytometry was used to analyze monocyte subsets (CD14++CD16-, CD14++CD16+, CD14+CD16++).
  • A multiplex assay measured 27 immune mediators.
  • Samples were collected before treatment, at SVR, and 1 year post-treatment in monoinfected chronic HCV patients.

Main Results:

  • While monocyte subset frequencies remained unchanged, monocyte activation markers (HLA-DR) decreased significantly at 1y compared to SVR.
  • Twenty-one immune mediators showed significant downregulation at 1y, with 55-80% of patients exhibiting this reduction.
  • Patients on DAA therapy demonstrated greater modulation of immune mediators at 1y.

Conclusions:

  • Successful DAA therapy for HCV does not alter monocyte subset frequencies long-term.
  • DAA treatment leads to reduced monocyte activation and sustained restoration of circulating immune mediators post-eradication.
  • These findings suggest a potential for long-term reversal of inflammation following successful HCV treatment.
Abstract

Keywords:
Antiviral agentsChronic hepatitis CInflammationLiver injuryMonocytesResponseSustained virological

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