Objective To determine the influence of viral factors and host cellular immunity on the response to interferon in the patients with chronic hepatitis C. Methods Forty patients with chronic hepatitis C were treated with interferon ?. The relationships between response to interferon a and HCV genotype, quasispecies heterogeneity, HCV RNA level and HCV specific cytotoxic T lymphocyte (HCV CTL) activity in the liver were analyzed. Results After 6 months of therapy, 21 patients had obtained end of treatment response (ETR), 10 Patients of which had obtained sustained response (SR). The other 19 patients got no response (NR). ETR rate in patients with genotype HCV1 infection (43.3%, 13/30) was significantly lower than that in patients with non HIV1 infection (80%, 8/10) [ P

BACKGROUNDTo determine the relationship between diversity of hepatitis C virus quasispecies and viremia, activity of liver disease and response to interferon therapy.

METHODSHCV quasispecies heterogeneity in 68 patients with chronic hepatitis C were detected by single stranded conformational polymorphism (SSCP) analysis of the HCV E2 hypervaribale region 1 (HVR1); of these, 48 were subsequently treated with interferon-alpha for 6 months.

RESULTSHVR1 was amplified in 61 patients. The average number of SSCP bands was 6.2+/-2.4. Quasispecies heterogeneity significantly correlated with serum HCV RNA levels (P<0.01), but not with serum ALT, AST levels and histological activity index (P>0.05). Of the patients who received interferon therapy, 43 were HVR1 positive. Patients who gained sustained response (n=11) had lower pre-treatement quasispecies heterogeneity (3.3+/-1.2) compared to those who had complete end-of-treatment response (ETR) with relapse (6.3+/-2.2, n=12, P<0.5) or no response (8.0+/-3.3, n=20, P<0.01). At the end of treatment, HVR1 could still be detected in 16 patients. The number of quasispecies heterogeneity in these patients decreased to 3.4+/-1.2, which was significantly lower than that in the patients who didn't receive interferon therapy (6.8+/-2.5, P<0.01). Of these 16 patients, 10 had change in quasispecies patterns.

CONCLUSIONSIncreased quasispecies heterogeneity can cause high HCV viremia, but it is not related to severity of liver disease. Quasispecies heterogeneity is another marker to predict the response to interferon-alpha in patients with chronic hepatitis C.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Female ; Genetic Heterogeneity ; Hepacivirus ; drug effects ; genetics ; Hepatitis C, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Polymorphism, Single-Stranded Conformational ; RNA, Viral ; blood ; Viremia ; virology

Objective: To evaluate the application of FISH testing of bcl-2/IgH gene translocation and IgH/L gene rearrangement in different stages of follicular lymphoma. Methods: In 32 follicular lymphoma cases, which were collected at Guangdong General Hospital from September 2014 to December 2016, the bcl-2/IgH gene ectopic state was detected by FISH while the IgH/L gene rearrangement was tested using PCR-GeneScan to analyze the relationship between bcl-2/IgH gene translocation, different stages of follicular lymphoma and clonal immunoglobulin (IgH/L) gene rearrangements. Results: From the paraffin sections of all 32 follicular lymphomas, 17 cases showed bcl-2/IgH gene translocation, and the percentages of FL1, FL2 and FL3 translocation were 12/13, 3/5 and 2/14, respectively. Among the 24 cases of IgH/L gene arrangements identified from the total sample, the occurrence rates of FL1, FL2 and FL3 gene arrangement were 7/13, 4/5 and 13/14, respectively. Spearman′s rank correlation analysis and χ² analysis showed that bcl-2/IgH gene translocation was negatively correlated with follicular lymphoma stage and the association was statistically significant. In more advanced stages of follicular lymphoma, the occurrence of bcl-2/IgH gene translocation tended to decrease with distinct FL1, FL2 and Fl3 gene expression (P<0.05). As IgH/L gene rearrangement in FL3 was higher than that in FL1 and FL2, its detection may be complimentary to FISH test for bcl-2/IgH gene translocation in diagnosing follicular lymphoma. Conclusions The combined use of FISH and PCR-GeneScan increases the positive rate of follicular lymphoma diagnosis, and this combination is more sensitive than FISH or clonal analysis only to detect the chromosomal abnormality or the gene rearrangement.