Potential role of hepatic stem/progenitor cells immunoexpression as a predictor to interferon response in Egyptian HCV patients

Abstract

In Egypt resides one of the highest hepatitis C virus (HCV) prevalences in the world (Thrift et al., 2016). The prevalence of chronic HCV infection is (10%) among persons who are 15-59 years old (Kandeel et al., 2017). Treatment of chronic HCV infection has evolved over the past three decades starting with interferon monotherapy followed by combination therapy using interferon plus ribavirin (RBV), and subsequently evolved to pegylated interferon (Peg-IFN) and ribavirin (Jothimani et al., 2013). Until the end of 2013, the only treatment for HCV was pegylated interferon plus ribavirin with sustained virological response (SVR) rates between 65% and 72% (Marciano et al., 2015). At that time, sofosbuvir based regimens were approved and released. Numerous barriers related to patient, provider, government and payers are known to affect HCV treatment accessibility. In developing countries, treatment-related costs constitute a major concern (Marciano et al., 2015). As pegylated interferon (Peg-IFN) and ribavirin treatment is expensive and has many adverse effects, searching for surrogate predictors of treatment response has thus drawn great attention (Shalaby et al., 2012). Moreover, owing to the global availability of new treatments under the cost-related limitations, careful identification of chronic HCV patients with greater risk of treatment failure to interferon based therapies become mandatory (Marciano et al., 2015).