Premium
Microbial translocation and T cell activation are modified by direct‐acting antiviral therapy in HCV‐infected patients
Author(s) -
Lattanzi Barbara,
Baroncelli Silvia,
De Santis Adriano,
Galluzzo Clementina Maria,
Mennini Gianluca,
Michelini Zuleika,
Lupo Marinella,
Ginanni Corradini Stefano,
Rossi Massimo,
Palmisano Lucia,
Merli Manuela
Publication year - 2018
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14994
Subject(s) - medicine , lipopolysaccharide binding protein , transaminase , hepatitis c virus , pathogenesis , immunology , ribavirin , liver transplantation , alanine transaminase , hepatitis c , gastroenterology , transplantation , virus , biology , inflammation , biochemistry , enzyme , acute phase protein
Summary Background Microbial translocation from the gut lumen has been involved in the pathogenesis of liver damage in hepatitis C virus (HCV) infection. Aim To investigate the impact of direct‐acting antiviral treatment on microbial translocation and T‐cell activation, in patients with hepatitis C‐related liver disease. Methods We enrolled two groups of HCV‐infected patients undergoing direct‐acting antiviral treatment: patients with fibrosis ≥F3 according to Metavir (Group ≥F3); patients with hepatitis C recurrence after liver transplantation and Metavir ≥F2 (Group Liver Transplantation + ≥F2). All patients were treated with direct‐acting antivirals based on ongoing guidelines. Surrogate biomarkers of microbial translocation (plasma concentrations of soluble‐ CD 14, lipopolysaccharide‐binding protein and intestinal fatty acid‐binding protein) were evaluated at baseline, at first month, at the end of treatment and 3 months later. T‐cell activation was measured by expression of CD 38+ HLA ‐ DR at the same time points, only in Group ≥F3. Results There were 32 patients in Group ≥F3 and 13 in Group LT + ≥F2. At baseline, levels of soluble‐ CD 14 and lipopolysaccharide‐binding protein were significantly higher in both groups vs healthy controls. Baseline soluble‐ CD 14 correlated with glutamic‐oxalacetic transaminase ( r = 0.384, P = 0.009) and glutamic‐pyruvic transaminase ( r = 0.293, P = 0.05). A significant decrease in plasma levels of surrogate microbial translocation biomarkers was observed during and after treatment in the two groups although values were not normalised. In Group ≥F3, CD 38+ HLADR + T‐cell expression was significantly decreased by direct‐acting antiviral treatment. Relapsers (9%) showed higher soluble‐ CD 14 levels at baseline. Conclusion Surrogate microbial translocation markers and T cell activation are increased in HCV‐infected patients with liver fibrosis and decrease during direct‐acting antiviral treatment.