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Distinct inflammatory imprint in non-cirrhotic and cirrhotic patients before and after direct-acting antiviral

Moana Witte1,2,3,4, Carlos Oltmanns1,2,3,4, Jan Tauwaldt1,2,3,4

  • 1Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School (MHH), Hannover, Germany.

Clinical and Molecular Hepatology
|June 4, 2025
PubMed

Insights

Hepatitis C virus (HCV) infection causes chronic liver disease. Even after treatment, persistent inflammation in cirrhotic patients is linked to liver cancer (HCC), highlighting the need for early intervention.

Area of Science:

  • Hepatology
  • Immunology
  • Oncology

Background:

  • Hepatitis C virus (HCV) infection leads to chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC).
  • Direct-acting antiviral therapy achieves high sustained virologic response (SVR) rates.
  • Long-term immune alterations and residual risks persist post-therapy, especially in cirrhotic patients.

Purpose of the Study:

  • To investigate soluble immune mediator (SIM) profiles in chronic HCV patients with varying cirrhosis status.
  • To assess changes in SIMs during and after antiviral therapy.
  • To identify SIMs associated with HCC development in HCV patients.

Main Methods:

  • Analyzed 75 SIM profiles in 102 chronic HCV patients (stratified by cirrhosis) at baseline, end of treatment, and follow-up.
  • Compared findings with 51 healthy controls.
  • Validated results in an independent cohort of 47 cirrhotic patients, including 17 who developed HCC.

Main Results:

  • Baseline SIM alterations were significant, with cirrhosis patients showing a more dysregulated inflammatory milieu.
  • Persistent SIM alterations were observed post-SVR, particularly in cirrhotic patients, correlating with liver stiffness.
  • Elevated IL-6, IL-8, urokinase plasminogen activator, and hepatocellular growth factor were linked to HCC development and fibrosis.

Conclusions:

  • Early antiviral intervention is crucial to prevent cirrhosis-related complications.
  • Persistent immune dysregulation post-HCV clearance impacts long-term outcomes, especially in advanced liver disease.
  • Further research into inflammation, fibrosis, and oncogenesis pathways is needed for biomarkers and therapies.
Abstract

Keywords:
CirrhosisDirect-acting antiviral therapyHepatitis C virusHepatocellular carcinomaSoluble inflammatory marker

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