The Association of HLA Class II Alleles with the Response to Alfa-Interferon/Ribavirin Therapy in Chronic Hepatitis C Patients

Abstract

Human Leucocyte Antigens (HLA) class II appears to play an important role in the individual’s immune response to viral infection. The present study was aimed at assessment of the relationship between HLA DRB1 alleles and the response to HCV combined therapy in Chronic Hepatitis C patients (CHC). We enrolled a total of 44 chronically infected HCV patients without Hepatitis B Virus (HBV) or Human Immunodeficiency Virus (HIV). Their mean age was 36.45±11.18 years (21-63). HLA-DRB1 typing was done by real time Polymerase Chain Reaction (PCR). ALT and Hemoglobin (Hb) levels were assessed as well as viral genotype was taken from patients' reports (HCV genotypes were 1, 2, 3 and 4 representing 13.6, 13.6, 4.5 and 68.18%, respectively). The most frequent alleles demonstrated among patients were DRB1*13 and DRB1*07 (31.8 and 36.4%, respectively). Analysis of DRB1 frequency between sustained responders and non responders revealed that DRB1*13 allele was significantly higher among sustained responders (p<0.001), while DRB1*07 allele was significantly higher among non responders (p<0.01). Female sex, HCV genotype 2 and pretreatment low serum HCV RNA level were associated with Sustained Virological Response (SVR). Also, elevated Alanine aminotransferase (ALT) level at the 1st week of therapy followed by return to baseline level at the 4th week and a decrease of the mean hemoglobin concentration at 4th week and 12th week of therapy were significantly associated with SVR. We concluded that the virological and special HLA patterns may possibly predict the response to combination therapy in CHC patients.