Highlights
- •Chronic hepatitis C may lead to hypergammaglobulinemia partly due to immune activation.
- •A rapid decrease of gamma globulins was seen after HCV eradication with antivirals.
- •HCV-RNA, ALT and fibrosis score levels were associated with gamma globulin decrease.
- •A role of HCV on B cells activation and gamma globulins production is hypothesized.
Abstract
Background
chronic viral infections by both HCV and HIV may lead to polyclonal activation of
B cells resulting in hypergammaglobulinemia. This study retrospectively analyzed the
effect of HCV eradication with interferon-free direct-acting antiviral agents (DAAs) on the gamma globulin levels in HCV-infected patients with or without HIV coinfection
to identify factors potentially associated with gamma globulins decrease.
Methods
The charts of patients treated with DAAs for HCV chronic infection between January
2015-June 2019 were retrospectively reviewed. Gamma globulin levels before treatment
and 12 weeks after the end of anti-HCV therapy were evaluated along with liver tests,
liver fibrosis stage by elastography, SVR achievement, HIV-coinfection. Multivariate
analyses were carried out to assess the factors and the potential confounders related
to the changes in gamma globulin levels.
Results
A significant decrease of gamma globulin concentration was found in both cirrhotic
and non-cirrhotic HCV-infected patients after treatment (from mean ± SD of 1.5 ± 0.44 g/dL
to 1.31 ± 0.37 g/dL; p = 0.0001). Adjusted linear regression analyses of serum gamma globulin changes from
baseline to SVR12 showed a positive significant association with pre-treatment gamma-globulin
levels (β-coefficient −0.23; p = 0.0001), Metavir fibrosis score (β-coefficient -0.74; p = 0.008), ALT values and baseline HCV-RNA levels > 800,000. No difference was found
between HIV-infected and HIV-uninfected patients.
Conclusions
Our study confirms previous preliminary observation of the decrease of serum gamma
globulins after HCV eradication either achieved with interferon-based therapy or with
DAAs, suggesting a leading role of the virus on the activation of B cell compartment
and gamma globulins production.
Keywords
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Article info
Publication history
Published online: January 21, 2020
Accepted:
January 13,
2020
Received in revised form:
December 8,
2019
Received:
October 14,
2019
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
