Elabd Naglaa S, Tayel Safaa I, Elhamouly Moamena S, Hassanein Shaimaa A, Kamaleldeen Samar M, Ahmed Fatma E, Rizk Mahmoud, Gadallah Abdelnaser A, Ajlan Soma E, Sief Ahmed S
Tropical Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Hepat Med. 2021 Mar 15;13:9-23. doi: 10.2147/HMER.S292251. eCollection 2021.
Treatment response to antiviral drugs is a challenging issue in patients with chronic hepatitis C virus (HCV) infection. Although microRNA-122 represents the majority of the microRNA content in hepatic tissues, few studies have evaluated its role in the treatment response, so we aimed to study its role in chronic HCV patients and in predicting the treatment response to direct-acting antivirals (DAAs).
The study included 125 chronic HCV patients (89 naïve and 36 with a prior failed peginterferon/ribavirin response) and 50 apparently healthy subjects. Complete blood count, liver function, α-fetoprotein, lipid profiles, serum creatinine, abdominal ultrasound, and FibroScan were assessed. Viral markers, HCV antibodies, and hepatitis B surface antigen were measured by enzyme-linked fluorescent immunoassay, with quantitative estimation of HCV RNA and microRNA-122 levels by real-time PCR.
The microRNA-122 level in HCV patients (those with a sustained virologic response 12 weeks after finishing therapy [SVR12] and non-responders) was significantly increased compared with controls and expressed more in non-responders versus SVR12 (=0.042). ROC curve analysis of microRNA-122 for differentiating HCV patients from healthy controls revealed that a cut-off point of >1.45 had a sensitivity of 67.20%, specificity of 94.0%, AUC=0.861, and <0.001; and for predicting response to treatment a cut-off point ≤5.66 could significantly (=0.022) predict the occurrence of SVR, with a sensitivity of 60.34%, specificity of 66.67%, and AUC=0.729. Logistic regression analysis showed significant values for microRNA-122 in multivariate and univariate analysis for the prediction of response to DAAs.
The results demonstrated the possible function of microRNA-122 as an indicative tool for distinguishing chronic HCV patients from controls and in the assessment of the therapeutic reaction to DAAs.
对于慢性丙型肝炎病毒(HCV)感染患者,抗病毒药物的治疗反应是一个具有挑战性的问题。尽管微小RNA - 122占肝组织中微小RNA含量的大部分,但很少有研究评估其在治疗反应中的作用,因此我们旨在研究其在慢性HCV患者中的作用以及预测对直接抗病毒药物(DAA)的治疗反应。
该研究纳入了125例慢性HCV患者(89例初治患者和36例既往聚乙二醇干扰素/利巴韦林治疗失败的患者)以及50名健康对照者。评估了全血细胞计数、肝功能、甲胎蛋白、血脂谱、血清肌酐、腹部超声和FibroScan。通过酶联荧光免疫测定法检测病毒标志物、HCV抗体和乙型肝炎表面抗原,通过实时PCR定量评估HCV RNA和微小RNA - 122水平。
与对照组相比,HCV患者(治疗结束后12周获得持续病毒学应答[SVR12]的患者和无应答者)的微小RNA - 122水平显著升高,且在无应答者中比SVR12患者表达更高(=0.042)。微小RNA - 122用于区分HCV患者与健康对照的ROC曲线分析显示,截断点>1.45时,灵敏度为67.20%,特异性为94.0%,AUC = 0.861,<0.001;对于预测治疗反应,截断点≤5.66可显著(=0.022)预测SVR的发生,灵敏度为60.34%,特异性为66.67%,AUC = 0.729。逻辑回归分析显示,在多变量和单变量分析中,微小RNA - 122对于预测对DAA的反应具有显著意义。
结果表明微小RNA - 122可能作为一种指示工具,用于区分慢性HCV患者与对照,并评估对DAA的治疗反应。