Biomarkers for hepatitis C
Acute hepatitis C is a mild or asymptomatic disease and in 70–80 % of cases it remains undiagnosed. This leads to chronic HCV infection, a leading cause of acute and chronic liver disease. If treated early with interferon-alpha, the acute phase of infection can be resolved in 95 % of the cases. As a result, it is necessary to discover biomarkers of early prognostic value that could predict viral clearance. Scientists on the EU-funded 'Host and viral factors in acute hepatitis C' (HEPACUTE) project set out to investigate the mechanisms responsible for chronic viral persistence and discover associated virus and host markers. Given the increased prevalence of chronic HCV infections in Egypt, one of the objectives of the study was to improve local detection and management through the establishment of a large network. The consortium employed state-of-the-art genomics, transcriptomics, and proteomics approaches alongside immunological and virological technologies. Various aspects of HCV infection were investigated, including host genetics, viral pathogenesis and immunity, proteomics and micro-RNAs. A clear association was evident between infection outcome and host genetic polymorphisms. Patients undergoing virus clearance compared to those with a chronic HCV infection could also be distinguished by the expression pattern of their dendritic cells. This finding clearly underscores the importance of these cells in HCV infection alongside regulatory T cells. During the study, researchers made another interesting observation. They found that in acute infection the majority of viral sequences get incorporated in defective particles. Coupled with information on the host immune response, this led to elucidation of the viral entry mechanism. Researchers envisage that this will help the design of preventative vaccines. A considerable part of the work was also devoted to the sequence diversity of HCV genomes in acute and chronic phases of the infection. Correlating this information with the capacity of the virus to evade immune responses represents an interesting, so far unexplored angle of the infection. The results of the project and the expertise gained in Egypt will undoubtedly improve the quality of care for hepatitis C patients and sustain future research.
Keywords
Biomarkers, hepatitis C, immune system, viral factors, acute infection
