title: Natural evolution of hepatitis C virus infection in hemodialysis Tunisian patients and CTLA-4 SNP's.
abstract: OBJECTIVE
  To analyze the polymorphisms of CTLA-4 gene involved in the response against hepatitis C virus (HCV) infection.
  
  
  METHODS
  We recruited 500 hemodialysed patients from several hemodialysis centers, all HCV-antibody positive, spread over different regions of Tunisia, as part of a national survey in 2008 conducted in the laboratory of immunology at the Charles Nicolle hospital Tunisia, classified into two groups G1 (PCR+) and G2 (PCR-) according to the presence or absence of viral RNA. Of these patients, 307 were followed prospectively on a viral molecular level over a period from 2002 to 2008, divided into two groups based on the persistence and viral clearance. PCR-RFLP was performed for the analysis of SNPs (+49) A/G and (+6230) G/A CTLA-4 for these 500 patients and 358 healthy controls.
  
  
  RESULTS
  Analysis of clinical and virological characteristics of our cohort suggests a nosocomial infection in our hemodialysed patients with transfusion history as a primary risk factor and a predominance of genotype 1b. The haplotype analysis revealed an increase of frequencies of GG (+49)/(CT60) CTLA-4 in the entire patients group compared to controls (P = 0.0036 and OR = 1.42; 95%CI: 1.12-1.79, respectively). This haplotype is therefore associated with susceptibility to HCV infection.
  
  
  CONCLUSIONS
  Our study suggests a possible role of CTLA-4 polymorphisms in the outcome of HCV infection in the Tunisian hemodialysed population.
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Leila
authors.initials: L
authors.lastname: Ksiaa Cheikhrouhou
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Yousr
authors.initials: Y
authors.lastname: Lakhoua-Gorgi
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Imen
authors.initials: I
authors.lastname: Sfar
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Salwa
authors.initials: S
authors.lastname: Jendoubi-Ayed
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Houda
authors.initials: H
authors.lastname: Aouadi
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Mouna
authors.initials: M
authors.lastname: Makhlouf
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Khaled
authors.initials: K
authors.lastname: Ayed
authors.affiliation: Leila Ksiaa Cheikhrouhou, Yousr Lakhoua-Gorgi, Imen Sfar, Salwa Jendoubi-Ayed, Houda Aouadi, Mouna Makhlouf, Khaled Ayed, Taieb Ben Abdallah, Immunology Research Laboratory of Kidney Transplantation and Immunopathology, Laboratoire de Recherche, LR03SP01, Tunis 1006, Tunisia.
authors.forename: Taieb
authors.initials: T
authors.lastname: Ben Abdallah
mesh_terms: D000328:Adult; D000368:Aged; D060908:CTLA-4 Antigen / Q000235:genetics*; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000175:diagnosis / Q000235:genetics* / Q000821:virology; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006239:Haplotypes; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000175:diagnosis / Q000235:genetics* / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction; D014416:Tunisia; D019562:Viral Load
chemical_list: D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human
keywords: CTLA-4 polymorphisms; Hemodialysis; Hepatitis C virus; Natural evolution