Background: chronic viral infections by both HCV and HIV may lead to polyclonal activation of B cells resulting in hypergammaglobulinemia. This study retrospectively analyzed the effect of HCV eradication with interferon-free direct-acting antiviral agents (DAAs) on the gamma globulin levels in HCV-infected patients with or without HIV coinfection to identify factors potentially associated with gamma globulins decrease. Methods: The charts of patients treated with DAAs for HCV chronic infection between January 2015-June 2019 were retrospectively reviewed. Gamma globulin levels before treatment and 12 weeks after the end of anti-HCV therapy were evaluated along with liver tests, liver fibrosis stage by elastography, SVR achievement, HIV-coinfection. Multivariate analyses were carried out to assess the factors and the potential confounders related to the changes in gamma globulin levels. Results: A significant decrease of gamma globulin concentration was found in both cirrhotic and non-cirrhotic HCV-infected patients after treatment (from mean ± SD of 1.5 ± 0.44 g/dL to 1.31 ± 0.37 g/dL; p = 0.0001). Adjusted linear regression analyses of serum gamma globulin changes from baseline to SVR12 showed a positive significant association with pre-treatment gamma-globulin levels (β-coefficient −0.23; p = 0.0001), Metavir fibrosis score (β-coefficient -0.74; p = 0.008), ALT values and baseline HCV-RNA levels > 800,000. No difference was found between HIV-infected and HIV-uninfected patients. Conclusions: Our study confirms previous preliminary observation of the decrease of serum gamma globulins after HCV eradication either achieved with interferon-based therapy or with DAAs, suggesting a leading role of the virus on the activation of B cell compartment and gamma globulins production.
Impact of HCV eradication with direct-acting antiviral agents on serum gamma globulin levels in HCV and HCV/HIV coinfected patients / L. Milazzo, L. van den Bogaart, S. Sollima, L. Oreni, A. Lai, V. Morena, C. Bonazzetti, L. Ridolfo Anna, S. Antinori. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 1879-0828. - (2020). [Epub ahead of print]
Titolo: | Impact of HCV eradication with direct-acting antiviral agents on serum gamma globulin levels in HCV and HCV/HIV coinfected patients |
Autori: | VAN DEN BOGAART, LORENA (Secondo) ANTINORI, SPINELLO (Ultimo) |
Parole Chiave: | Direct active antivirals; HCV infection; HCV/HIV coinfection; Hypergammaglobulinemia |
Settore Scientifico Disciplinare: | Settore MED/07 - Microbiologia e Microbiologia Clinica Settore MED/42 - Igiene Generale e Applicata Settore MED/17 - Malattie Infettive |
Data di pubblicazione: | 2020 |
Rivista: | |
Tipologia: | Article (author) |
Data ahead of print / Data di stampa: | 21-gen-2020 |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.ejim.2020.01.006 |
Appare nelle tipologie: | 01 - Articolo su periodico |
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