T cell subsets in chronic hepatitis C patients genotype 4 who achieved SVR following DAAs Therapy

BackgroundT cells are the primary effector cells that mediate viral clearance in spontaneous recovery from HCV infection and T cell dysfunction is a hallmark of progression to chronic HCV infection. Material and methodsThis study included 49 well charcterised HCV genotype 4-infected patients at Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt, who were enrolled to receive direct acting antiviral therapy for hepatitis C. Immuno-phenotyping was performed to assess the expression of multiple T cell lineage, activation and inhibitory receptors. This was done before treatment, during treatment, at end of treatment and one year after treatment. 50 patients were also enrolled as control. ResultsOur data showed, significant increase in the percentages of CD8+ cells as compared to control group. The percentages of PD-1 expression on the CD8+ T-cell population were signifecntly elevated in patients before treatment (p<0.001). Significant increase in Treg (CD4+CD25hFoxP3+) subsets was noticed in comparison with control pateints. The expression of the inhibitory and activated markers in CD8+ T-cells was markedly reduced but more obvios in exhausted cytotoxic T cells compared to baseline finding (p<0.001). exhausted (PD1+CD8+) T-cells from HCV+ individuals reduced markedly after 4 weeks of DAA therapy (by 3 folds, p <0.001). Intereatingly it started to increase gradually again at the end of treatment and after 1 year but the increase doesnt reach levels noticed in healthy control subjects. ConclusionUnderstanding the mechanisms of immune dysfunction and barriers to immune restoration after HCV cure will aid in better understanding of the remaining negative long-term health outcomes for HCV patients and the possibility of HCC development.