title: Human cytomegalovirus infection inhibits response of chronic hepatitis-C-virus-infected patients to interferon-based therapy.
abstract: OBJECTIVE
  Cytomegalovirus (CMV) is a ubiquitous pathogen that infects the majority of humans. Co-infection of CMV and hepatitis C virus (HCV) may deteriorate the prognosis of HCV-infected patients. This study was conducted to examine the role of CMV reactivation in determining the response rate to treatment with interferon and ribavirin therapy in chronic HCV patients.
  
  
  METHODS
  Viral loads and genotyping were assessed using reverse transcription polymerase chain reaction and Innolipa systems, respectively. Reactivation of CMV in HCV patients who were all positive for CMV immunoglobulin G antibodies was tested by amplification of the gB1 gene using the end-point dilution quantitative-nested polymerase chain reaction method.
  
  
  RESULTS
  CMV DNA was detected in 89.7% of non-responders and in 34.6% of sustained virological responders. Patients with reactivated CMV had significantly higher fibrosis scores (72.7%) than those with undetectable CMV DNA (23.8%, P=0.002). Patients with positive CMV had higher rates of non-response and relapse (79.5%) than those with negative CMV DNA (19%). Chronic HCV patients with latent CMV had higher rates of response (81%) to treatment than those with reactivated CMV (20.5%, P<0.001). Therefore, HCV patients with reactivated CMV and advanced fibrosis were least likely to achieve a sustained virological response following interferon therapy. This possibility is reduced to 50% of its original value in patients with reactivated CMV without fibrosis.
  
  
  CONCLUSIONS
  Besides the staging of liver fibrosis, CMV co-infection should be considered as an extremely important factor when designing predictive models for HCV response to interferon treatment.
authors.affiliation: Department of Biomedical Technology, National Research Center, Cairo, Egypt.
authors.forename: Noha G
authors.initials: NG
authors.lastname: Bader el-Din
authors.forename: Mai
authors.initials: M
authors.lastname: Abd el-Meguid
authors.forename: Ashraf A
authors.initials: AA
authors.lastname: Tabll
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Anany
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
authors.forename: Naglaa
authors.initials: N
authors.lastname: Zayed
authors.forename: Amr
authors.initials: A
authors.lastname: Helmy
authors.forename: Abdel Rahman
authors.initials: AR
authors.lastname: el-Zayady
authors.forename: Ahmed
authors.initials: A
authors.lastname: Barakat
authors.forename: Mostafa K
authors.initials: MK
authors.lastname: el-Awady
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004534:Egypt; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012254:Ribavirin / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014759:Viral Envelope Proteins / Q000235:genetics; D019562:Viral Load; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D004279:DNA, Viral; D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D014759:Viral Envelope Proteins; C040495:glycoprotein B, Simplexvirus; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a