ABSTRACT
Since the development and approval of new direct-acting antiviral (DAA) drugs, chronic hepatitis C virus (HCV) infection is now considered a curable disease. However, the emphasis on DAA therapies might disregard other preventive measures, and limits the strategy for a clinical cure rather than comprehensive disease control. The Qatar National plan for HCV control was launched in December 2014 to prioritize and proactively manage HCV with the ultimate aim of eliminating viral hepatitis. The plan is based on four pillars: primary prevention, early detection, clinical management, and continuous monitoring. This report describes the activities undertaken in Qatar to prepare for the programme and the early results of its initial phase, given the fact that countries with comprehensive HCV plans are providing better access to care and prevention
ABSTRACT
Intercellular adhesion molecules [ICAMs] constitute an integral part of the immune reactions in various clinical conditions. Soluble forms shed or released from effector cells retain ligand-binding activity and their measurement in body fluids has proved as useful markers of cellular and endothelial reactivity. In this work, circulating soluble intercellular adhesion molecule-1 [sICAM-1], soluble vascular cell adhesion molecule [sVCAM-1], soluble E and P-selectins [sE- and sP-selectins] were measured by enzyme immuno-assay [EIA] in the serum of 27 liver transplant recipients who received cadaveric grafts within the previous 13 years and who were showing different clinical courses. 13 patients were having stable graft function [Stable group] and 14 showing evidence of chronic rejection +/- viral pathology [Unstable group]. 12 patients with hepatitis C virus [HCV] cirrhosis still on the waiting list for liver transplantation were also included [Pre-transplant group], in addition to 15 healthy subjects matched for age and sex [Control group]. A significant increase in sICAMs was noted in all patient groups as compared to controls except those stable non-viral cases who showed sICAM levels comparable to the control subjects. Patients transplanted for non-viral aetiology had their levels markedly lower than viral cases, whether stable or unstable. Stable cases showing viral recurrence had their sICAM levels comparable to the pre-transplanted cases with an insignificant increase in the unstable group. We could conclude that sICAM levels can be used to monitor graft integrity in the non-viral cases but their use in patients transplanted for viral causes would not be justified