Dynamic Changes of Monocytes and NK Cells of CHC Patient Treated by DAAs
Dynamic Changes of Monocytes and NK Cells of CHC Patient Treated by DAAs
Recently,surprisingly and unexpectedly increased aggressiveness and high rates of HCC
 recurrence (28%(16/58) and 29%(17/59), respectively) have been reported in patients who
 cleared HCV with DAAs after achieving a complete response to resection or local ablation
 within only 6 months of therapy. The authors hypothesized that the rapid eradication of HCV
 and control of liver inflammation would impact anti-tumoral immune control, which in turn
 might contribute to the neoplastic cells proliferation. Conversely, three independent
 prospective French cohorts failed to reveal an increased risk of HCC recurrence after DAAs
 treatment in CHC patients after receiving curative cancer treatments.Although the impact of
 DAAs treatment on the rate of HCC occurrence or recurrence still remain unclear, it would be
 more important to pay attention to the immunological changes of CHC patients treated with
 DAAs.Up to now, little was known about the immunological changes of chronic hepatitis C (CHC)
 patients treated with direct-acting antiviral agents (DAAs), here we try to explore the
 effect of antiviral treatment of CHC patients with DAAs on the frequency of monocytes, NK
 cells and cytokines that promote their activation.
15 treatment-naive CHC patients and 10 healthy controls were recruited. Patients were
 examined before DAAs therapy (0w) and at weeks 4 (4w) and weeks 12 (12w) of the therapy. The
 percentage of monocytes,NK cells of the peripheral blood were analyzed by flow cytometry.
 Serum cytokines IL-12, IL-18, CXCL10, CXCL11, sCD14 and sCD163 were measured by enzyme linked
 immunosorbent assay.
Inclusion Criteria:

 -  Positive serum Anti-HCV antibody or serum HCV-RNA, CHC patients without any treatment

 Exclusion Criteria:

 Patient has a history of clinical signs/symptoms of hepatic decompensation (Child-Pugh
 Grade B or C) or ascites, esophageal variceal bleeding, hepatic encephalopathy, or
 spontaneous bacterial peritonitis.

 Patient has a history of hepatocellular carcinoma (HCC) or suspected symptoms of HCC, such
 as suspicious foci on imaging studies and/or serum alpha-fetoprotein (AFP)>50ng/mL.

 Patient has received IFN or other immunomodulatory treatment within 52 weeks before
 Screening.

 Patient has a medical condition that requires frequent use of systemic acyclovir or
 famciclovir.

 Patient has a medical condition that requires frequent use of systemic corticosteroids,
 however topical and inhaled corticosteroids are allowed.

 Patient has used hepatotoxic drugs within one month. Patient has overtaken alcohol
 (>40g/day) or abused illicit drugs in recent one year.

 Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female
 after conception and until the termination of gestation, confirmed by a positive urine
 pregnancy test.

 Patients who co-infected with HAV, HBV, HDV, HEV,HIV(human immunodeficiency virus ) Patient
 has one or more additional known primary or secondary causes of liver disease, other than
 hepatitis C (e.g., alcoholism, autoimmune hepatitis).

 History of malignancy of any organ system.