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P0739 : Impact of serum apolipoprotein profiles in chronic HCV infection: difference between HCV genotypes 1B and 2
POSTERS Africa (SSA) region having among the highest prevalences. In Western countries the modes of transmissions are widely established. However, in developing countries, especially in SSA, the transmission pathways and risk factors are not well known. The primary aim of the study was to conduct a meta-analysis on the HCV sero-prevalence in SSA, and examine the impact of region, cohort and year of study on the estimates. The second aim was to perform a literature review of risks factors for HCV infection in SSA. Methods: Articles published from January of 2000 to December of 2013 on HCV prevalence and risks factors were assessed. Studies were excluded if they were missing information on prevalence, year of study, serologic assay used, or were not from sub-Saharan countries. Study populations were grouped by cohorts based on different risk factors (i.e. general population, HIV positive, chronic illness, high risk, and blood donors). Results: Data from 265 studies representing the SSA region were. A total of 146 articles meeting the inclusion criteria. Studies came from 26 countries across 4 sub-regions in SSA. Overall, the prevalence estimate was 4.9% (95% CI: 1.9–12.0). The prevalence varied by region. There was a higher prevalence in studies from current years (4.4%), as opposed to earlier years (2.9%). Prevalence also varied by population cohort. Table 1 depicts the prevalence estimates by population cohort, region, and year of study. A paucity of data limited the possibility to conduct a meta-analysis on risk factors for HCV infection. However, risk factors consistently associated with HCV infection amongst others include: gender, traditional circumcision, ethnic group, history of past injections, HIV and HBV co-infection, education level, and occupation (farming). Table: Prevalence of HCV infection in Sub-Saharan Region. Meta-analysis results a Group
Prevalence, %
95% CI
Overall Cohort General population Blood donors HIV positive High risk population Chronic illness African Region Central Eastern Western Southern Year 2000 to 2005 2006 to 2013
4.9
0.2–12.0
4.2 1.5 3.0 11.8 7.5
3.1–5.7 0.8–3.1 0.9–10.0 1.7–79.0 0.2–236.0
7.0 3.0 3.9 0.3
4.6–10.0 1.5–5.7 2.0–7.5 0.06–17.0
2.9 4.4
1.8–4.6 2.9–6.6
a
Random effect model.
Conclusions: There is limited primary data on HCV prevalence. This meta-analysis, however, suggests that HCV prevalence has increased and is higher than previously reported estimates. There is even less data on HCV risk factors, limiting our understanding of present day transmission pathways. Such knowledge gaps limit the ability to create screening and treatment guidelines relevant to this region. P0739 IMPACT OF SERUM APOLIPOPROTEIN PROFILES IN CHRONIC HCV INFECTION: DIFFERENCE BETWEEN HCV GENOTYPES 1B AND 2 N. Seki1 , T. Nagano1 , T. Sugita1 , Y. Aida1 , H. Abe1 , Y. Aizawa1 . 1 Division of Gastroenterology and Hepatology, Jikei University Katsushika Medical Center, Tokyo, Japan E-mail: [email protected] Background and Aims: The life cycle of hepatitis C virus (HCV) is tightly associated with host lipoprotein metabolic pathways. Many articles have demonstrated prominent lipid S602
metabolism disturbances with HCV genotype 3a (G3a). Although HCV G3a infection is extremely rare in Japan, abnormalities of lipids/lipoproteins are recognized in Japanese HCV G1b/G2 patients. In order to clarify abnormality of lipoprotein in chronic HCV infection, we examined serum apolipoprotein profiles, because apolipoprotein is present on the outer surface of lipoprotein particles and plays a crucial role in lipoprotein metabolism. Methods: Fasting serum apolipoprotein profiles of 358 subjects with active or cleared HCV infection were examined. Basic laboratory data including lipids were examined at the same time. Concentrations of apo A-I, A-II, B, C-II, C-III, and E were measured by immunoturbidimetric assay using a commercially available kit according to the manufacturer’s instructions (Sekisui Medical Co., LTD, Tokyo, Japan). Subsequently, the association between chronic HCV infection and serum apolipoprotein levels was determined using multiple regression analysis. To clarify the significance of the genotype (G1b or G2) of actively infected HCV patients on the serum level of apolipoproteins/lipids, similar multiple regression analysis using indicator variables was performed. Results: Active HCV infection was associated with high serum levels of apo A-II (p < 0.001) and low serum levels of apo C-II (p = 0.04) and C-III (p < 0.001). In contrast, active HCV infection was not found to be a significant factor affecting any alteration of serum lipid levels. HCV infection with both G1b and G2 was associated with low serum levels of apo C-III (p < 0.001), whereas only HCV G1b infections caused high levels of apo A-II (p < 0.001) and low levels of apo B (p = 0.047) and C-II (p = 0.04). Additionally, IFNL3 rs8099917 nonmajor genotype (TG/GG) was associated with high levels of apoA-II and low levels of serum apo B in chronic HCV G1b infection. Conclusions: Our results demonstrate that active HCV infection is distinctively associated with characteristic serum apolipoprotein profiles. The influence on apolipoprotein profiles varies with different HCV genotypes. Moreover, genotype of IFNL3 affected serum apolipoproteins in HCV G1b infection. P0740 USEFULNESS OF INTERFERON LAMBDA4-, HLA CLASS IIPOLYMORPHISM AND KILLER-IMMUNGLOBULIN-LIKE RECEPTOR-2DL3:C1/C1 TO PREDICT SPONTANEOUS CLEARANCE OF ACUTE HEPATITIS C VIRUS INFECTION 2 S. Beinhardt1 , M. Mandorfer1 , B.A. Payer1 , A.F. Stattermayer ¨ , C. Datz3 , A. Maieron4 , F. Huber5 , E. Dulic-Lakovic6 , R. Stauber7 , G. Fischer8 , M. Gschwantler6 , P. Ferenci9 , H. Hofer2 . 1 Department of Internal Medicine III, Division of Gastroenterology and Hepatology, 2 Department of Internal Medicine III, Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, 3 Hospital Oberndorf, Hospital Oberndorf, Oberndorf, 4 Hospital Elisabethinen, Hospital Elisabethinen, Linz, 5 Otto Wagner Spital, Otto Wagner Spital, 6 Department of Internal Medicine IV, Wilhelminen Spital, Vienna, 7 Department of Gastroenterology and Hepatology, Medical University of Graz, Graz, 8 Department of Blood Group Serology and Transfusion Medicine, 9 Department of Internal Medicine III, Division ofGastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria E-mail: [email protected] Background and Aims: Spontaneous resolution of acute hepatitis C virus infection (AHC) largely depends on the patient’s immunogenetic background. Besides IL-28B (rs12979860), Interferon-L4/ rs469415590- and HLA-class-II/rs4273729 polymorphisms (PMs) as well as the detectability of killer-cell-immunoglobulin-like-receptor with its ligands (KIR)2DL3:HLA-C1/C1 might influence spontaneous clearance (SC) of AHC. We aimed to investigate if these genetic factors predict SC in patients with acute HCV-infection. Patients and Methods: IL-28B/rs12979860-, IFNL4/rs469415590and HLA-class-II/rs4273729 polymorphisms were determined in
Journal of Hepatology 2015 vol. 62 | S263–S864
Prevalence, %
95% CI
Overall Cohort General population Blood donors HIV positive High risk population Chronic illness African Region Central Eastern Western Southern Year 2000 to 2005 2006 to 2013
4.9
0.2–12.0
4.2 1.5 3.0 11.8 7.5
3.1–5.7 0.8–3.1 0.9–10.0 1.7–79.0 0.2–236.0
7.0 3.0 3.9 0.3
4.6–10.0 1.5–5.7 2.0–7.5 0.06–17.0
2.9 4.4
1.8–4.6 2.9–6.6
a
Random effect model.
Conclusions: There is limited primary data on HCV prevalence. This meta-analysis, however, suggests that HCV prevalence has increased and is higher than previously reported estimates. There is even less data on HCV risk factors, limiting our understanding of present day transmission pathways. Such knowledge gaps limit the ability to create screening and treatment guidelines relevant to this region. P0739 IMPACT OF SERUM APOLIPOPROTEIN PROFILES IN CHRONIC HCV INFECTION: DIFFERENCE BETWEEN HCV GENOTYPES 1B AND 2 N. Seki1 , T. Nagano1 , T. Sugita1 , Y. Aida1 , H. Abe1 , Y. Aizawa1 . 1 Division of Gastroenterology and Hepatology, Jikei University Katsushika Medical Center, Tokyo, Japan E-mail: [email protected] Background and Aims: The life cycle of hepatitis C virus (HCV) is tightly associated with host lipoprotein metabolic pathways. Many articles have demonstrated prominent lipid S602
metabolism disturbances with HCV genotype 3a (G3a). Although HCV G3a infection is extremely rare in Japan, abnormalities of lipids/lipoproteins are recognized in Japanese HCV G1b/G2 patients. In order to clarify abnormality of lipoprotein in chronic HCV infection, we examined serum apolipoprotein profiles, because apolipoprotein is present on the outer surface of lipoprotein particles and plays a crucial role in lipoprotein metabolism. Methods: Fasting serum apolipoprotein profiles of 358 subjects with active or cleared HCV infection were examined. Basic laboratory data including lipids were examined at the same time. Concentrations of apo A-I, A-II, B, C-II, C-III, and E were measured by immunoturbidimetric assay using a commercially available kit according to the manufacturer’s instructions (Sekisui Medical Co., LTD, Tokyo, Japan). Subsequently, the association between chronic HCV infection and serum apolipoprotein levels was determined using multiple regression analysis. To clarify the significance of the genotype (G1b or G2) of actively infected HCV patients on the serum level of apolipoproteins/lipids, similar multiple regression analysis using indicator variables was performed. Results: Active HCV infection was associated with high serum levels of apo A-II (p < 0.001) and low serum levels of apo C-II (p = 0.04) and C-III (p < 0.001). In contrast, active HCV infection was not found to be a significant factor affecting any alteration of serum lipid levels. HCV infection with both G1b and G2 was associated with low serum levels of apo C-III (p < 0.001), whereas only HCV G1b infections caused high levels of apo A-II (p < 0.001) and low levels of apo B (p = 0.047) and C-II (p = 0.04). Additionally, IFNL3 rs8099917 nonmajor genotype (TG/GG) was associated with high levels of apoA-II and low levels of serum apo B in chronic HCV G1b infection. Conclusions: Our results demonstrate that active HCV infection is distinctively associated with characteristic serum apolipoprotein profiles. The influence on apolipoprotein profiles varies with different HCV genotypes. Moreover, genotype of IFNL3 affected serum apolipoproteins in HCV G1b infection. P0740 USEFULNESS OF INTERFERON LAMBDA4-, HLA CLASS IIPOLYMORPHISM AND KILLER-IMMUNGLOBULIN-LIKE RECEPTOR-2DL3:C1/C1 TO PREDICT SPONTANEOUS CLEARANCE OF ACUTE HEPATITIS C VIRUS INFECTION 2 S. Beinhardt1 , M. Mandorfer1 , B.A. Payer1 , A.F. Stattermayer ¨ , C. Datz3 , A. Maieron4 , F. Huber5 , E. Dulic-Lakovic6 , R. Stauber7 , G. Fischer8 , M. Gschwantler6 , P. Ferenci9 , H. Hofer2 . 1 Department of Internal Medicine III, Division of Gastroenterology and Hepatology, 2 Department of Internal Medicine III, Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, 3 Hospital Oberndorf, Hospital Oberndorf, Oberndorf, 4 Hospital Elisabethinen, Hospital Elisabethinen, Linz, 5 Otto Wagner Spital, Otto Wagner Spital, 6 Department of Internal Medicine IV, Wilhelminen Spital, Vienna, 7 Department of Gastroenterology and Hepatology, Medical University of Graz, Graz, 8 Department of Blood Group Serology and Transfusion Medicine, 9 Department of Internal Medicine III, Division ofGastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria E-mail: [email protected] Background and Aims: Spontaneous resolution of acute hepatitis C virus infection (AHC) largely depends on the patient’s immunogenetic background. Besides IL-28B (rs12979860), Interferon-L4/ rs469415590- and HLA-class-II/rs4273729 polymorphisms (PMs) as well as the detectability of killer-cell-immunoglobulin-like-receptor with its ligands (KIR)2DL3:HLA-C1/C1 might influence spontaneous clearance (SC) of AHC. We aimed to investigate if these genetic factors predict SC in patients with acute HCV-infection. Patients and Methods: IL-28B/rs12979860-, IFNL4/rs469415590and HLA-class-II/rs4273729 polymorphisms were determined in
Journal of Hepatology 2015 vol. 62 | S263–S864