Z Gastroenterol 2020; 58(01): e62
DOI: 10.1055/s-0039-3402274
Poster Visit Session V Viral Hepatitis and Immunology: Saturday, February 15, 2020, 11:00 am – 11:45 am, Lecture Hall P1
Georg Thieme Verlag KG Stuttgart · New York

Soluble inflammatory molecules do not completely normalize despite early treatment of acute symptomatic hepatitis C

T Khera
1   Essen University Hospital, Essen, Germany
,
Y Du
1   Essen University Hospital, Essen, Germany
,
J Hengst
2   Hannover Medical School, Hannover, Germany
,
K Deterding
1   Essen University Hospital, Essen, Germany
,
S Hardtke
2   Hannover Medical School, Hannover, Germany
,
B Strunz
3   Karolinska Institutet, Stockhlolm, Sweden
,
N Bjorkstrom
3   Karolinska Institutet, Stockhlolm, Sweden
,
K Port
2   Hannover Medical School, Hannover, Germany
,
MP Manns
2   Hannover Medical School, Hannover, Germany
,
M Cornberg
2   Hannover Medical School, Hannover, Germany
,
H Wedemeyer
1   Essen University Hospital, Essen, Germany
2   Hannover Medical School, Hannover, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 January 2020 (online)

Also available at
 

Background and Aim:

Acute hepatitis C virus (HCV) infection has been associated with altered phenotypes and function of several immune cell populations and soluble inflammatory mediators (SIM). Successful treatment of chronic hepatitis C with DAA"s has been associated with alterations of SIM. However, no complete SIM restoration was observed. We hypothesized that early DAA treatment of symptomatic acute hepatitis C with DAAs may normalize most SIM – in contrast to treatment of persistent infection.

Methods:

In this study we made use of a unique cohort of 20 acute HCV patients who cleared HCV with a 6 weeks course of ledipasvir/sofosbuvir. As controls healthy donors (n = 20) and chronic non-cirrhotic patients (n = 25) were included. We applied a Proximity Extension assay (PEA) that uses high throughput, multiplex immunoassay measuring 92 proteins across 96 samples simultaneously.

Results:

Profound SIM alterations were observed in acute HCV patients with marked upregulation of IL-6, µPA, & TRAIL while few parameters were down-regulated compared to healthy controls (e.g.s2B4). During the course of treatment and follow-up, the majority of SIM decreased with initiation of DAA but did not normalize until follow-up week 24 (e.g. CDCP1, IL-18). Of note, SIM that were downregulated before treatment remained suppressed while other parameters only declined to lower values during treatment and follow-up (e.g.Il-17).

Conclusions:

Antiviral treatment of acute hepatitis C leads to deep changes in the soluble inflammatory milieu. However, early treatment of very recent infection does not completely normalize altered SIM patterns. These findings may have implications for HCV re-exposure.