Can Direct-Acting Antiviral Treatment Change the Immunologic Risk Profile in Patients Infected with Hepatitis C Virus Who Are on the Cadaveric Waiting List?

Abstract

Background. In patients with hepatitis C virus (HCV) infection, the activation of theimmune system by the virus or viral proteins leads to the production of numerous autoantibodiesand clinical manifestations. The objectives of this study were to investigate therelationship between HCV and anti-HLA antibodies, as well as the effect of viremia on theantibody response and of direct-acting antivirals (DAAs) on anti-HLA antibodypersistence in patients on the waiting list for a cadaveric kidney transplant.Methods. A total of 395 patients from the cadaveric renal transplant waiting list wereincluded in the study. The patients were grouped according to the presence of HCVinfection, and patients with HCV positivity were further divided into a spontaneousclearance group and a persistent group. Anti-HLA antibodies were examined before andafter treatment of the patients in the persistent group. The One Lambda Luminexmethod (Thermo Fisher Scientific, Waltham, MA, United States) was used to assessboth HLA class I and II alleles and the anti-HLA antibody profile.Results. Anti-HLA class I and II antibodies were detected in 48.2% and 55.1%,respectively, of the patients infected with HCV and in 21.8% and 20.4%, respectively, ofthe patients who were not infected. The level of anti-HLA A3, A11, B72, B52, Cw6, Cw16,DR3, and DQ4 antibodies was significantly higher in the patients infected with HCV.There was no statistically significant difference in class I and II antibody titrationbetween the HCV-infected spontaneous clearance group and the persistent group (classI mean fluorescence intensity [MFI] SD: 13,583 6224, 13,450 9540, P ¼ .808;Class II MFI SD: 13,000 8673, 8440 8302, P ¼ .317, respectively). There was nosignificant difference in the class I and class II anti-HLA antibody profile and titrationin the persistent group after treatment with DAAs (P > .05).Conclusions. The results of this study demonstrated that hepatitis C DAA treatment didnot change the anti-HLA antibody profile and titration.