慢性丙型肝炎病毒感染患者经口服直接抗病毒药物治疗后的 B 细胞克隆性。
B-cell Clonality in HCV-Induced Patients Treated with Oral Direct-Acting Antiviral Agents.
机构信息
Specialized Medical hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Chemistry, Faculty of Science, Menofeia University, Menofeia, Egypt.
出版信息
Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2187-2193. doi: 10.31557/APJCP.2023.24.6.2187.
BACKGROUND
Hepatitis C virus (HCV) is a worldwide' health problem as Egypt has a very high prevalence (14.7%) that may affect the B-Lymphocytes, and in some cases leading to an expansion of monoclonal B-cell detected by immunoglobulin heavy chain (IgH) gene rearrangement. Therefore, we aimed to assess the occurrence of IgH gene rearrangement in Egyptian chronic HCV patients and studying the effect of oral direct-acting antiviral (DAAs) therapy on regression of the clonality markers.
METHODS
78 Egyptian patients with chronic HCV infection were included in this study and polymerase chain reaction (PCR) analysis was used to detect IgH rearrangement based on standardized PCR protocols of the BIOMED-2 international guidelines study.
RESULTS
Clonal IgH showed a significant increase of HCV-RNA expression and correlated with increased alanine transaminase (ALT) in all patients, while a significant increase of kappa and lambda free light chain observed only in clonal IgH with lymphoproliferative disorders (LPD) patients. A total of 37.17% (29/78) IgH clonality was detected in all patients (7.69% with LPD and 29.48% without LPD). 37% of these IgH clonality disappeared with HCV eradication after DAAs regimen.
CONCLUSIONS
we concluded that different DAAs regimen with or without RBV is safe and effective for the treatment of Egyptian patients, but its effect is partially and not completely in the eradication of IgH clonality. Also, using IgH rearrangement in patients with chronic HCV is helpful as indicator in patients at high risk for prediction of LPD.
背景
丙型肝炎病毒（HCV）是一个全球性的健康问题，因为埃及的 HCV 感染率非常高（14.7%），这可能会影响 B 淋巴细胞，并且在某些情况下，导致单克隆 B 细胞的扩增，通过免疫球蛋白重链（IgH）基因重排检测到。因此，我们旨在评估埃及慢性 HCV 患者中 IgH 基因重排的发生情况，并研究口服直接作用抗病毒（DAA）治疗对克隆性标志物消退的影响。
方法
本研究纳入了 78 例埃及慢性 HCV 感染患者，并使用聚合酶链反应（PCR）分析根据 BIOMED-2 国际指南研究的标准化 PCR 方案检测 IgH 重排。
结果
克隆性 IgH 显示 HCV-RNA 表达显著增加，并与所有患者的丙氨酸转氨酶（ALT）升高相关，而仅在具有淋巴增生性疾病（LPD）的克隆性 IgH 患者中观察到κ和λ游离轻链的显著增加。在所有患者中检测到 37.17%（29/78）的 IgH 克隆性（7.69%的 LPD 和 29.48%的无 LPD）。在 DAA 方案治疗后，有 37%的这些 IgH 克隆性消失，HCV 被清除。
结论
我们得出结论，不同的 DAA 方案（含或不含 RBV）对埃及患者的治疗是安全有效的，但它的效果是部分的，而不是完全消除 IgH 克隆性。此外，在慢性 HCV 患者中使用 IgH 重排作为预测 LPD 高危患者的指标是有帮助的。
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