New Biomarkers Could Shine Beacon for Personalised Hepatitis C Therapy

BLOOD tests can be used to predict which chronic hepatitis C patients will respond to interferon-based therapy.

“While highly effective direct-acting antivirals (DAAs) have become the new standard of care for patients with hepatitis C, these treatments come with a hefty price tag,” said lead study author Dr Philipp Solbach, Hannover Medical School, Hannover, Germany. “There may still be a role for the more affordable interferon-based therapies, and with this new information, we can better assess which patients will respond to this less-expensive treatment.”

Using a cohort of hepatitis C virus (HCV)-infected patients who received interferon-based therapies, the researchers found that levels of oxidised low-density lipoprotein (LDL) in the blood predicted the patient’s response to treatment. LDL, often known as ‘bad cholesterol’, is easily identified through blood testing and can be used as a surrogate marker for oxidised LDL.

Once oxidised LDL was established as a marker of treatment response, the authors studied hepatitis C transmission cell to cell using an in vitro culture system. They discovered that oxidised LDL inhibited cell-to-cell spread, suggesting a mechanism underlying the relationship between oxidised LDL and a sustained viral response to interferon therapy.

“The study provides important information about the mechanism whereby HCV infection occurs,” added Dr Rebecca G Wells, Associate Editor of Cellular and Molecular Gastroenterology and Hepatology. “While DAAs are coming to the forefront in HCV therapy, this study serves an important role in advancing our understanding of this complex virus.”

This research boosts the likelihood that drugs that inhibit viral entry into cells may be useful add-ons to interferon therapy for HCV. In addition, similar approaches could be effective for other chronic viral infections. Further studies trialling entry-inhibiting drugs are required.

Hepatitis C, a major cause of illness and death from hepatocellular carcinoma and end-stage liver disease, chronically infects approximately 160 million people worldwide.

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