Role of lymphocyte-to-monocyte ratio as a predictive marker for diabetic coronary artery disease: A cross-sectional study

BACKGROUND The lymphocyte to monocyte ratio(LMR)is considered a marker of systemic inflammation in cardiovascular disease and acts as predictor of mortality in coronary artery disease.AIM To investigate the predictive role of LMR in diabetic coronary artery disease patients.METHODS This cross-sectional study was conducted at tertiary care super-specialty hospital at New Delhi,India.A total of 200 angiography-proven coronary artery disease(CAD)patients were enrolled and grouped into two categories:Group I[CAD patients with type 2 diabetes mellitus(T2DM)and glycated hemoglobin(HbA1c)levels≥6.5%],and Group II(CAD patients without T2DM and HbA1c levels<6.5%).Serum lipoproteins,HbA1c,and complete blood count of enrolled patients were analyzed using fully automatic analyzers.RESULTS The logistic regression analysis showed an odds ratio of 1.48(95%CI:1.28-1.72,P<0.05)for diabetic coronary artery disease patients(Group I)in unadjusted model.After adjusting for age,gender,diet,smoking,and hypertension history,the odds ratio increased to 1.49(95%CI:1.29-1.74,P<0.01)in close association with LMR.Further adjustment for high cholesterol and triglycerides yielded the same odds ratio of 1.49(95%CI:1.27-1.75,P<0.01).Receiver operating characteristic curve analysis revealed 74%sensitivity,64%specificity,and 0.74 area under the curve(95%CI:0.67-0.80,P<0.001),suggesting moderate predictive accuracy for diabetic CAD patients.CONCLUSION LMR showed positive association with diabetic coronary artery disease,with moderate predictive accuracy.These findings have implications for improving CAD management in diabetics,necessitating further research and targeted interventions.

Identification of the epitopes on HCV core protein recognized by HLA-A2 restricted cytotoxic T lymphocytes

AIM: To identify hepatitis C virus(HCV) core protein epitopes recognized by HLA-A2 restricted cytotoxic T lymphocyte (CTL). METHODS: Utilizing the method of computer prediction followed by a 4h(51)Cr release assay confirmation. RESULTS: The results showed that peripheral blood mononuclear cells (PBMC) obtained from two HLA-A2 positive donors who were infected with HCV could lyse autologous target cells labeled with peptide &quot;ALAHGVRAL (core 150-158)&quot;. The rates of specific lysis of the cells from the two donors were 37.5% and 15.8%, respectively. Blocking of the CTL response with anti-CD4 mAb caused no significant decrease of the specific lysis. But blocking of CTL response with anti-CD8 mAb could abolish the lysis. CONCLUSION: The peptide (core 150-158) is the candidate epitope recognized by HLAA2 restricted CTL.

Hepatitis C virus in human B lymphocytes transformed by Epstein-Barr virus in vitro by in situ reverse transcriptase-polymerase chain reaction

AIM: To study persistence and replication of hepatitis C virus (HCV) in patients' peripheral blood mononuclear cells (PBMC) cultured in vitro. METHODS: Epstein Barr virus (EBV) was used to transform the hepatitis C virus from a HCV positive patient to permanent lymphoblastoid cell lines (LCL). Positive and negative HCV RNA strands of the cultured cells and growth media were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) each month. Core and NS5 proteins of HCV were further tested using immunohistochemical SP method and in situ RT-PCR. RESULTS: HCV RNA positive strands were consistently detected the cultured cells for one year. The negative-strand RNA in LCL cells and the positive-strand RNA in supernatants were observed intermittently. Immunohistochemical results medicated expression of HCV NS3 and C proteins in LCL cytoplasm mostly. The positive signal of PCR product was dark blue and mainly localized to the LCL cytoplasm. The RT-PCR signal was eliminated by overnight RNase digestion but not DNase digestion. CONCLUSION: HCV may exist and remain functional in a cultured cell line for a long period.

Effect of Low Dose Radiation on Intracellular Calcium and Protein Kinase C in Lymphocytes

It is first reported in the present paper that whole-body irradiation (WBI) with low dose X-rays could increase intracellular calcium ions ([Ca2+]i) and stimulate protein kinase C (PKC) activity of mouse lymphocytes. Following WBI of male Kunming micc With 75 mGy X-rays at a dose rate of 12.5 mGy/min the mobilization of [Ca2+]i with Con A in CD4+ and CD8+ Cells in the thymus and spleen was potentiated and the amplitude of [Ca2+], mobilization in thymocytes in response to anti-CD3 monoclonal antibody increased with time from 4 to 24 h following low dose radiation. The PKC activity in the homogenate of spleen was markedly stimulated 12 h after WBl with 75 mGy, reaching its peak value at 24-48 h and coming down to lower than normal on day 7. However, the PKC activity in the separated T lymphocytes reached its peak value at 12 h and that in the B lymphocytes reached its peak value on day 4, both coming down to below control on day 7. The implications of this facilitation of signal transduction in T lymphocytes in the mechanism of immunoenhancement after low dose radiation were discussed

Novel biomarkers for patients with idiopathic acute anterior uveitis:neutrophil to lymphocyte ratio and platelet to lymphocyte ratio

AIM： To assess the levels of the neutrophil to lymphocyte ratio（N/L） and the platelet to lymphocyte ratio（P/L） in patients with idiopathic acute anterior uveitis（AAU） and to compare with healthy controls.METHODS： Thirty-six male patients with idiopathic AAU and 36 male healthy subjects were enrolled in this retrospective study.Complete ophthalmological examination and complete blood count measurements results of all subjects were evaluated.RESULTS： There was a significant difference in N/L and P/L between idiopathic AAU and control groups（P=0.006,P=0.022）.Also,correlation analysis revealed a significant correlation between C-reactive protein（CRP） and N/L（P= 0.002;r=0.461）.CONCLUSION： Our study for the first time provides evidence of N/L and P/L may be useful biomarkers in patients with idiopathic AAU.N/L is correlated with CRP,so it can be a useful biomarker to predict the prognosis in idiopathic AAU.

Effects of“Moxibustion Serum”on Proliferation and Phenotypes of Tumor Infiltrating Lymphocytes

Tumor infiltrating lymphocytes (TIL) were cultured with “moxibustion serum”(MS), and the results were examined by flow cytometry. The results indicated that MS could enhance the proliferation of TIL,accelerate it to reach the exponential growth phase, and assist recombinant interleukin 2 (rIL-2) to enhance successively the percentage of CD3^+ positive cells, maintain the number of CD4^+ positive T cells, promote greatly the percentage of CD8^+ positive T cells among TILs, and reverse the CD4^+/CD8^+ ratio. Such cooperative effects rely on relative specificity of acupoints. It is suggested that MS is beneficial to the growth of TIL both in the aspects of proliferation and phenotypes.

The Changes of Protein Kinase C Activity in Peripheral Blood Lymphocytes in the Patients with Obstructive Jaundice and the Implication

The roles of protein kinase C signal pathway in the pathogenesis of obstructive jaundice were studied. PKC from cytosolic and membrane fractions of peripheral blood lymphocytes in 51 patients with obstructive jaundice and 16 cases of normal controls was isolated and purified. The activities of PKC were determined by radioactive isotope γ 32 P ATP catalyzing assay. The results showed that the total PKC activities in PBL in the patients with obstructive jaundice were significantly increased as compared with those in the normal controls . Moreover, the membrane PKC activities and their percentages of the total PKC activities were higher in obstructive jaundice group than in those in the normal controls . The total PKC activities in PBL in the patients with obstructive jaundice were significantly positively correlated with the levels of soluble IL 2 receptor and the degree of jaundice in serum. It was concluded that the activities of PKC signal pathway was related with the degree of T BIL. PKC signal pathway might took part in the activation of T lymphocytes in the patients with obstructive jaundice and play an important role in the immune regulation and the assessment of pathosis in the patients with obstructive jaundice.

Comments to ＂Neutrophil-to-lymphocyte ratio compared to N-terminal pro- brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure＂

We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure＂ published in Journal of Geriatric Cardiology with great interest, However, we have some comments regarding this study.

Effects of Vitamin C and NADH on in Vitro Proliferative Function of Human Lymphocytes Exposed to Pesticides （Mancozeb and Metribuzin）

Antioxidants such as vitamin C and NADH can protect against pesticide adverse effects on immune function. The aim of this work was to study the in vitro effects of vitamin C and NADH on the proliferative responses of human lymphocytes exposed to pesticides （Mancozeb fungicide and Metribuzin herbicide） and on Thl and Th2 cytokine secretion. Their possible protective role on intracellular stress oxidative induced by pesticides was also investigated. Peripheral blood lymphocytes were isolated using differential centrifugation on a density gradient of Histopaque. They were cultured with mitogen concanavalin A （Con A）, Mancozeb and Metribuzin （50 μM） in the presence or the absence of vitamin C （50 μM） or NADH （50 μM）. Proliferation （MTT assay）, IL-2, INFγ and IL-4 （Elisa kits）, oxidative markers （intracellular superoxide anion, hydroperoxides, carbonyl proteins, GSH, catalase and SOD） were determined, The results showed that pesticides were immunosuppressive and decreased cytokine secretion with a shift away from to Thl phenotype. These immunomodulatory properties were accompanied by an increase in lymphocyte intracellular oxidative stress. The presence of vitamin C or NADH, in the medium, exhibited protective effects in human lymphocytes by inhibiting pesticide---induced lymphocyte proliferation suppression, inflammatory status and oxidative stress generation. In conclusion, vitamin C and NADH can result in a safe and effective method to reduce pesticide adverse effects and help to restore immune function.

Clinical application of neutrophil/lymphocyte ratio combined with high sensitive C reactive protein in evaluation of community acquired pneumonia

Objective:To explore the application value of neutrophil/lymphocyte ratio (NLR) combined with high sensitive C reactive protein (hs-CRP) in the evaluation of community acquired pneumonia (CAP). Methods:From November 2015 to October 2016, 58 cases of CAP patients admitted in our department were selected as research objects and were divided into low risk group and high risk group according to the PSI score and CURB-65 standard for evaluation. They were divided into improved group (48 cases) and death group (10 cases) according to prognosis. Hs-CRP was determined by immunoturbidimetric assay, procalcitonin (PCT) by immunofluorescence, NLR by count method of laser scattering, and white blood (WBC) was counted. The differences in WBC, PCT, NLR and hs-CRP between different risk groups were compared, and the correlation was evaluated using Spearman's rank correlation analysis method. The changes in indexes were observed in the improved and death cases. Results:The high risk group had higher NLR, PCT and hs-CRP than low risk group (P<0.05), while no significant difference was found in WBC (P>0.05). No correlation was found between NLR and WBC, while a strong correlation was found between hs-CRP and PCT. The WBC, PCT, NLR and hs-CRP levels were significantly lower in the improved group than the death group (P<0.05). Conclusions:NLR combined with hs-CRP, WBC, and PCT has a good assessment of the severity of CAR, and high levels of NLR, hs-CRP, WBC, and PCT predict the severity of the disease and poor prognosis.

Follicular helper T lymphocytes in health and disease

A correct antibody response requires the participation of both B and T lymphocytes and antigen presenting cells. In this review we address the role of follicular helper T lymphocytes(T FH) in this reaction. We shall focus on the regulation of their development and function in health and disease. T FH can be characterized on the basis of their phenotype and the pattern of secretion of cytokines. This fact is useful to study their participation in the generation of antibody deficiency in primary immunodeficiency diseases such as common variable immunodeficiency, X-linked hyper Ig M syndrome orX-linked lymphoproliferative disease. Increased numbers of T FH have been demonstrated in several autoimmune diseases and are thought to play a role in the development of autoantibodies. In chronic viral infections caused by the human immunodeficiency virus, hepatitis B or C virus, increased circulating T FH have been observed, but their role in the protective immune response to these agents is under discussion. Likewise, an important role of T FH in the control of some experimental protozoan infections has been proposed, and it will be important to assess their relevance in order to design effective vaccination strategies.

降钙素原、C反应蛋白及CD4^(+) T淋巴细胞在人类免疫缺陷病毒感染患者结核分枝杆菌感染早期诊断中的应用价值

目的:探讨降钙素原(procalcitonin,PCT)、C反应蛋白(C reactive protein,CRP)及CD4^(+)T淋巴细胞水平在人类免疫缺陷病毒(HIV)感染患者结核分枝杆菌(Mycobaterium tuberculosis,MT)感染早期诊断中的应用价值。方法:选取2021年1月—2024年5月常州市第三人民医院收治的69例HIV感染患者为研究对象,根据是否合并MT感染分为单纯HIV感染组(n=35)和HIV合并MT感染组(n=34)。检测两组患者的PCT、CRP及CD4^(+)T淋巴细胞水平,比较两组以上指标的差异,并对HIV合并MT感染患者的以上指标进行相关性分析。通过受试者操作特征(ROC)曲线评估PCT、CRP及CD4^(+)T淋巴细胞水平在MT感染早期诊断中的效能。结果:HIV合并MT感染组的PCT、CRP水平均显著高于单纯HIV感染组,CD4^(+)T淋巴细胞水平显著低于单纯HIV感染组,差异均有统计学意义(P<0.05)。HIV合并MT感染患者中,PCT与CRP水平呈显著正相关(rs=0.607,P<0.001),CD4^(+)T淋巴细胞水平与PCT、CRP均呈负相关(rs=-0.751、-0.700,P<0.001)。ROC曲线分析显示,PCT、CRP及CD4^(+)T淋巴细胞联合检测MT感染的曲线下面积(AUC)为0.911,特异度为97.1%,均显著高于单独检测。结论:PCT、CRP及CD4^(+)T淋巴细胞水平的联合检测在HIV患者MT感染的早期诊断中有较高价值。

急性缺血性脑卒中患者LCR与病情、短期预后的关系

目的探讨急性缺血性脑卒中(AIS)患者淋巴细胞/C反应蛋白比值(LCR)与病情、短期预后的关系。方法选取2022年8月至2023年7月西安交通大学第一附属医院收治的102例AIS患者,根据美国国立卫生研究院脑卒中量表(NIHSS)将其分为轻度组(n=34)、中度组(n=52)、重度组(n=16),根据随访3个月的预后将其分为预后良好组(n=77)和预后不良组(n=25)。比较不同病情、不同短期预后AIS患者外周血淋巴细胞(LYM)、C反应蛋白(CRP)、LCR水平;采用受试者工作特性(ROC)曲线评估外周血LYM、CRP、LCR对AIS患者短期预后的预测价值;采用多因素Logistic回归模型探讨AIS患者短期预后的影响因素。结果外周血LYM、LCR水平:轻度组>中度组>重度组,外周血CRP水平:轻度组<中度组<重度组,差异有统计学意义(P<0.05)。预后不良组外周血LYM、LCR水平低于预后良好组,外周血CRP水平高于预后良好组,差异有统计学意义(P<0.05)。外周血LYM、CRP、LCR预测AIS患者短期预后的曲线下面积(AUC)分别为0.752、0.869、0.902。预后不良组年龄≥60岁占比、糖尿病史占比、发病至入院时间、入院时NIHSS评分、病灶最大直径大于预后良好组,差异有统计学意义(P<0.05)。年龄≥60岁、发病至入院时间≥6 h、入院时NIHSS评分≥20分、LCR水平降低是AIS患者短期预后不良的独立危险因素(P<0.05)。结论外周血LCR水平降低与AIS患者病情加重、短期预后不良有关,并且对患者短期预后具有一定的预测价值。

Interferon therapy in hepatitis Cleading to chronic type 1 diabetes

AIM: To review the prevalence,clinical data and course of interferon-associated type 1 diabetes in chronic hepatitis C virus(HCV) infection.METHODS: Search of all interferon(INF)-related type 1diabetes mellitus(T1DM) cases published in the English literature from 1992 to December 2013 according to the key words: chronic hepatitis C infection,diabetes mellitus type 1,insulin dependent diabetes mellitus,and interferon treatment.We found 107 cases and analyzed their clinical and laboratory data and long-term followup.Due to the predominance of cases described in Japanese literature,we analyzed separately cases of Caucasian and Japanese origin.In addition we describe a representative case with HCV who developed INFrelated T1 DM.RESULTS: Our data show that INF treatment increases the risk of developing T1 DM by 10-18 fold compared with the corresponding general population and the median age of onset was 43 years(range: 24-66 years) in Caucasians and 52 years(range: 45-63 years) in Japanese.Most patients developed T1 DM during INF treatment,after a median time-period of 4.2 and 5.7 mo in Caucasian and Japanese groups,respectively.The clinical course was characterized by a fulminant course with abrupt severe hyperglycemia or ketoacidosis,a high titer of anti-islet autoantibodies and almost all patients(105/107) permanently required insulin therapy with a follow-up of up to 4 years.A substantial number of patients had evidence for other autoimmune disorders mainly thyroid diseases(25% and 31% in Caucasian and Japanese groups,respectively).CONCLUSION: INF-associated T1 DM in HCV has a fulminant course,often associated with other autoimmune diseases,and results almost inevitably in permanent insulin therapy requirement.

治疗前淋巴细胞与C反应蛋白比值对结外NK/T细胞淋巴瘤预后的判断价值

目的:探讨治疗前淋巴细胞与C反应蛋白比值(LCR)对结外NK/T细胞淋巴瘤(ENKTL)预后的判断价值。方法:回顾性分析郑州大学第一附属医院收治的203例初诊为ENKTL患者的临床资料,ROC曲线得到LCR预测5 a总生存期(OS)的最佳截断值,并根据截断值将患者分为两组,绘制Kaplan-Meier生存曲线,采用Cox回归分析无进展生存期(PFS)和OS的影响因素。结果:LCR预测5 a OS的最佳截断值为0.19,低LCR组患者预后较差(P<0.001)。Cox回归分析结果表明,低LCR组ENKTL患者预后较差,PFS和OS的HR(95%CI)分别为0.462(0.336~0.636)和0.381(0.275~0.527)。结论:治疗前LCR可影响ENKTL预后,低LCR患者的预后较差。

LMR联合hs-CRP对急性胰腺炎患者并发急性肾损伤的诊断价值

目的探讨淋巴细胞计数与单核细胞计数比值(LMR)联合超敏C反应蛋白(hs-CRP)对急性胰腺炎(AP)患者并发急性肾损伤(AKI)的诊断价值。方法选取2019年10月至2023年11月该院收治的226例AP患者作为研究对象,根据住院期间是否并发AKI分为AKI组(62例)和非AKI组(164例)。采用血液分析仪检测淋巴细胞计数和单核细胞计数,计算LMR;采用特定蛋白免疫分析仪检测hs-CRP水平。收集所有研究对象入院时肝功能、血脂等生化指标。采用Pearson相关分析AP患者LMR与hs-CRP水平的相关性。采用受试者工作特征(ROC)曲线分析LMR联合hs-CRP对AP患者并发AKI的诊断价值。采用多因素Logistic回归分析AP患者并发AKI的影响因素。结果AKI组低密度脂蛋白胆固醇、血肌酐、丙氨酸转氨酶、天冬氨酸转氨酶水平均高于非AKI组,差异均有统计学意义(P<0.05)。AKI组LMR低于非AKI组,hs-CRP水平高于非AKI组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,AP患者LMR与hs-CRP水平呈负相关(r=-0.645,P<0.001)。LMR联合hs-CRP检测对诊断AP患者并发AKI的曲线下面积(AUC)高于LMR、hs-CRP单独检测的AUC(Z=2.531,P=0.011;Z=3.244,P=0.001)。多因素Logistic回归分析结果显示,血肌酐、LMR、hs-CRP是AP患者并发AKI的影响因素(P<0.05)。结论AP并发AKI患者LMR水平明显降低,hs-CRP水平明显升高,二者联合检测对AP患者并发AKI有一定诊断价值。

淋巴细胞与单核细胞比值、C反应蛋白与前白蛋白比值检测对甲型流感病毒重症感染婴幼儿的临床价值

目的 探讨淋巴细胞与单核细胞比值(LMR)、C反应蛋白与前白蛋白比值(CRP/PA)预测甲型流感病毒重症感染婴幼儿的临床价值。方法 选取2019年1月至2022年12月泰安市妇幼保健院儿内科住院的婴幼儿甲型流感病毒感染重症组(192例)、轻症组(187例)及健康对照者(393例),检测其血常规、CRP及PA水平,计算中性粒细胞/淋巴细胞比值(NLR)、LMR、血小板/淋巴细胞比值(PLR)、系统免疫炎症指数(SII)、CRP/PA。采用受试者工作特征(ROC)曲线和Logistic回归分析LMR、CRP/PA对甲型流感病毒重症感染的诊断及预测价值。结果 与对照组和轻症组比较,重症组NLM、PLR、SII、CRP/PA均显著升高,LMR显著降低(分别为1.09、88.07、310.75、0.05和3.90,P<0.05)。与对照组相比,轻症组CRP/PA显著升高,LMR显著降低(分别为0.04和6.31,P<0.05)。ROC曲线显示,诊断重症感染时,CRP/PA的特异度最高,为96.1%,LMR、CRP/PA联合检测的灵敏度、ROC曲线下面积(AUC)均优于单项检测(分别为88.5%、0.941)。LMR、CRP/PA联合检测对轻症与重症感染鉴别诊断的灵敏度、特异度和AUC均优于单项检测(分别为76.4%、60.2%、0.707)。校正年龄、性别及NLM、PLR、SII后,CRP/PA的升高与LMR的降低与甲型流感病毒感染独立相关,并区分轻症和重症。结论 甲型流感病毒感染患儿CRP/PA升高与LMR降低,还有助于区分轻症和重症,可为预测感染严重程度的指标,LMR、CRP/PA联合分析对轻重症感染的鉴别诊断具有重要价值。

细菌性肺炎患者血清LTB4、NLCR及CRP/PA变化及其与肺损伤程度的关系

目的探讨细菌性肺炎患者血清白三烯B4(LTB4)、中性粒细胞/淋巴细胞计数比值(NLCR)及C-反应蛋白与前白蛋白(CRP/PA)比值变化及其与肺损伤程度的关系。方法回顾性选取172例细菌性肺炎患者(观察组)和同期140例健康体检者(对照组)的临床资料,根据肺损伤程度,将患者分为轻中度组和重度组。比较各组LTB4、NLCR及CRP/PA水平,分析LTB4、NLCR及CRP/PA联合评估患者肺损伤程度的价值。结果与对照组比较,观察组LTB4、NLCR及CRP/PA水平更高(P<0.05);与轻中度组比较,重度组LTB4、NLCR及CRP/PA水平更高(P<0.05);ROC结果显示,LTB4、NLCR和CRP/PA评估患者肺损伤程度的AUC为0.793、0.717、0.758,三者联合评估患者肺损伤程度的AUC为0.933,高于单项评估(P<0.05)。结论LTB4、NLCR及CRP/PA在细菌性肺炎患者中表达水平均会升高,且其均与肺损伤程度有关,其联合评估肺损伤程度的价值较高。

Combination of "low-dose" ribavirin and interferon alfa-2a therapy followed by interferon alfa-2a monotherapy in chronic HCV-infected nonresponders and relapsers after interferon alfa-2a monotherapy

AIM To report on the efficacy, safety and tolerability of interferon alfa-2a combined with a "low dose" of ribavirin for relapsers and non responders to alpha interferon monotherapy.METHODS Thirty-four chronic hepatitis C virus-infected non-responders to interferon alfa2a monotherapy (a course of at least 3 months treatment) and 13 relapsers to interferon alfa 2a monotherapy (a dose of 3 to 6 million units three times per week for at least 20 weeks but not more than 18 months) were treated with the same dose of interferon alfa-2a used before (3 to 6 million units three times per week) and ribavirin (10 mg/ kg daily) for 6 months. In complete responders, interferon alfa-2a was administered for further 6 months at the same dose used before as monotherapy.RESULTS Seven (20.6%) of 34 non-responders stopped the combined therapy due to adverse events, including two patients with histological and clinical Child A cirrhosis. In 17/27 (63%)non-responders, the combined therapy was stopped after three months because of non-response. Ten of the 27 non-responders completed the 1;2-month treatment course. At a mean follow up of 28 months (16- 37 months)after the treatment, 4/10 (15%) previous non-responders still remained complete responders,All 13 previous relapsers completed the 12-month treatment course. At a mean follow up of 22months (9 - 36 months) after treatment, 6/13(46%) the previous relapsers were stillsustained complete responders.CONCLUSION Our treatment schedule of the combined therapy for 6 months of interferon alfa2a with a low dose of ribavirin (10 mg/kg/day)followed by 6 months of interferon alfa-2amonotherapy is able to induce a sustainedcomplete response rate in 15% of non-responders and 46% of relapsers with chronic hepatitis C virus-related liver diseases comparable to those obtained with the standarddoses of ribavirin 1000 - 1200 mg/day.Randomized prospective controlled trials using lower total amounts of ribavirin in combination with interferon should be performed.

Impact of hepatitis C virus heterogeneity on interferon sensitivity:An overview

Hepatitis C virus(HCV)is a major cause of liver disease worldwide.HCV is able to evade host defense mechanisms,including both innate and acquired immune responses,to establish persistent infection,which results in a broad spectrum of pathogenicity,such as lipid and glucose metabolism disorders and hepatocellular carcinoma development.The HCV genome is characterized by a high degree of genetic diversity,which can be associated with viral sensitivity or resistance(reflected by different virological responses)to interferon(IFN)-based therapy.In this regard,it is of importance to note that polymorphisms in certain HCV genomic regions have shown a close correlation with treatment outcome.In particular,among the HCV proteins,the core and nonstructural proteins(NS)5A have been extensively studied for their correlation with responses to IFN-based treatment.This review aims to cover updated information on the impact of major HCV genetic factors,including HCV genotype,mutations in amino acids 70 and91 of the core protein and sequence heterogeneity in the IFN sensitivity-determining region and IFN/ribavirin resistance-determining region of NS5A,on virological responses to IFN-based therapy.