RESUMO
Background: Egypt has the highest prevalence of hepatitis C virus [HCV] infection in the world [15%-25%] and the main [90%] genotype is type 4. Prevalence in Egyptian children was found to be 3% in Upper Egypt and 9% in Lower Egypt. Various human leucocytic antigen [HLA] alleles have been linked either persistence or clearance of the hepatitis C virus [HCV]. Several studies have aimed to identify the involvement of HLA with different outcomes of HCV infection, but the results have not been consistent
Aim of the work: To identify HLA association with different outcomes as regard treatment of chronic HCV [CHC] in Egyptian children with pegylated interferon-alpha2b [Peg-IFN-alpha-2b] and ribavirin [RBV]
Patients and methods: Forty clinically and laboratorial children diagnosed as CHC genotype 4 [ages 3-18 years, 14 females and 26 males]. Patients were treated using Peg-IFN-alpha 2b [Peg Intron] at a dosage of 60 ug/m[2] per week subsutaneously and RBV 15 mg/kg per day orally for 48 weeks. Serum HCV ribonucleic acid [RNA] was measured at the baseline, at the 12[th], 24[th] and 48[th] weeks during treatment, and after 24 weeks of post-treatment [study weeks 72]. Sustained virologic responders [SVR] were defined as patient with undetectable HCV-RNA in the serum at 24 weeks post-treatment, while non-responders defined as HCV-RNA remains detectable throughout the treatment phase. Genomic DNA was extracted from 1 ml peripheral blood in tubes containing EDTA. HLA typing was performed by polymerase chain reaction followed by detection using sequence-specific oligonucleotides probes
Results: Twenty-nine out of forty patients [72.5%] showed a sustained virological responders to Peg-IFN/RBV therapy, whereas eleven [27.5%] non-responders did not. The frequencies of DRB1[asterisk]11 was significantly higher in sustained virological responders than non-responders. On the other hand, DRB1[asterisk] 07 allele was significantly higher in non-responders than SVR. We also found that no statistically significant difference between SVR and non-responders as regards the demographic, laboratory and liver histopathology characteristics of patients
Conclusion: There is a trend of association between certain HLA alleles and the response to Peg-IFN/RBV in HCV infected children and a study on large number of patients to confirm this association is worthy