Likely Predictors of Hepatitis C Severity Identified

In patients infected with Hepatitis C virus (HCV), viral evolution and host protein levels predict rapid disease progression.

Acute infection with HCV one of five viruses that cause acute and chronic hepatitis, causes fatigue, jaundice, and loss of appetite.

Between 70% and 80 % of people infected with HCV develop chronic infection, which over a patient's lifetime may result in severe liver diseases, such as liver cancer and cirrhosis. The World Health Organization (WHO; Geneva, Switzerland) estimates that 130 million to 170 million people live with chronic hepatitis C. Approximately 2.7 million to 3.9 million of those people live in the United States, according to the Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA).

The new study involved samples collected from six patients who were infected with hepatitis C via contaminated blood transfusions in the 1970s, before the virus was identified. The patients' symptoms and clinical outcomes were closely followed from the day they received the transfusion for up to 30 years, and ranged from mild and stable chronic hepatitis C to rapid disease progression and death.

Dr. Alter and his National Institutes of Health (NIH; Bethesda, MD, USA) Clinical Center colleagues periodically collected blood serum samples from each of the six patients. Dr. Farci and her National Institute of Allergy and Infectious Diseases (NIAID; Bethesda, MD, USA; www.niaid.nih.gov) colleagues used up to 17 of these archived samples per patient to obtain and analyze a total of 1,876 genetic sequences of the hepatitis C virus. The genetic sequences were used to reconstruct the evolution of two particular hepatitis C genes, E1 and E2, and the team analyzed the types of genetic changes that took place in order to understand their relationship with disease progression. They also studied the levels of 39 blood serum proteins during the acute and chronic phases of disease.

"We thoroughly characterized the biological changes that occurred in these patients, and we discovered that patients who developed rapidly progressive disease had specific changes in their blood that were detectable since the early acute phase of infection," said Dr. Farci.

Patients with rapid disease progression had significantly higher levels of a protein known as MCP-1 in their blood, which is believed to play a major role in the development of liver fibrosis, and, eventually, cirrhosis. Moreover, in these patients, the genetic changes in the virus as it evolved over time were less likely to result in changes to the virus proteins.

Thus, it is possible to predict rate of progression of the disease Hepatitis C by testing the patient's blood for changes in proteins and testing changes in viral proteins.

Related Links:
World Health Organization
Centers for Disease Control and Prevention
National Institutes of Health