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Eur. J. Intern. Med. · May 2020
Impact of HCV eradication with direct-acting antiviral agents on serum gamma globulin levels in HCV and HCV/HIV coinfected patients.
- Laura Milazzo, Lorena van den Bogaart, Salvatore Sollima, Letizia Oreni, Alessia Lai, Valentina Morena, Cecilia Bonazzetti, Lisa Ridolfo Anna, and Spinello Antinori.
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di, Milano, Italy. Electronic address: laura.milazzo@unimi.it.
- Eur. J. Intern. Med. 2020 May 1; 75: 50-54.
Backgroundchronic 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.MethodsThe 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.ResultsA 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.ConclusionsOur 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.Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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