Genetic association analyses reveal a role for vitamin D insufficiency in hepatitis C virus-associated hepatocellular carcinoma development

Background: V itamin D insufficiency has been associated with the occurrence of various types of cancer, but causal relationships remain elusive. Methods: Associations between t he r isk o f HCV-related HCC development and CYP2R1 , GC, and DHCR7 genotypes, which are genetic determinants of reduced 25-OH-vitamin D3 (25[OH]D3) serum levels, were determined. Results: A t otal of 5604 HCV-infected patients, 1279 with a nd 4325 without progression to HCC, w ere identified. The well-known association between 25(OH)D3 s erum levels and variations in CYP2R1 ( rs1993116, rs10741657), GC ( rs2282679), a nd DHCR7 ( rs7944926, rs12785878) g enotypes was also apparent in patients w ith chronic hepatitis C. The same genotypes of t hese single nucleotide polymorphisms (SNPs), w hich are associated with reduced 25(OH)D3 s erum levels, were significantly associated with HCV-associated HCC (P=0.07 [OR=1.13] for CYP2R1 , P=0.007 [OR=1.56] for GC, P=0.003 [OR=1.42] for DHCR7; ORs for risk genotypes). In contrast, no association between t hese genetic variations and the o utcome of antiviral therapy with pegylated interferon-α and ribavirin ( P>0.2 for e ach SNP) or liver fibrosis progression rate (P>0.2 for each SNP) was observed, s uggesting a specific influence o f the genetic d eterminants of 25(OH)D3 s erum levels o n hepatocarcinogenesis. Conclusions: Our data suggest a relatively weak but functionally relevant role for vitamin D in the prevention of HCV-related HCC development. Controlled clinical trials to assess the benefit of vitamin D supplementation in HCVinfected patients with advanced liver fibrosis or cirrhosis are warranted.

Role of seipin in lipid droplet morphology and hepatitis C virus life cycle.

Infectious hepatitis C virus (HCV) particle assembly starts at the surface of lipid droplets, cytoplasmic organelles responsible for neutral fat storage. We analysed the relationship between HCV and seipin, a protein involved in lipid droplet maturation. Although seipin overexpression did not affect the total mean volume occupied by lipid droplets nor the total triglyceride and cholesterol ester levels per cell, it caused an increase in the mean diameter of lipid droplets by 60 %, while decreasing their total number per cell. The latter two effects combined resulted in a 34 % reduction of the total outer surface area of lipid droplets per cell, with a proportional decrease in infectious viral particle production, probably due to a defect in particle assembly. These results suggest that the available outer surface of lipid droplets is a critical factor for HCV release, independent of the neutral lipid content of the cell.

Suscetibilidade de cercas-vivas, quebra-ventos e plantas invasoras ao vírus da leprose e sua transmissão para laranjeiras por Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae)

Objetivou-se avaliar a potencialidade de algumas plantas freqüentes em pomares cítricos de hospedar o vírus da leprose, transmitido por Brevipalpus phoenicis (Geijskes). Foram utilizadas as seguintes plantas: Hibiscus sp. L., Malvaviscus mollis DC., Grevillea robusta A. Cunn., Mimosa caesalpiniaefolia Benth., Bixa orellana L., Commelina benghalensis L., Bidens pilosa L., Sida cordifolia L. e Ageratum conyzoides L.. Duas criações-estoque do ácaro foram realizadas, sendo uma sobre frutos com sintomas de leprose e outra sobre frutos sem sintomas. De cada planta hospedeira do ácaro, escolheram-se duas folhas, delimitando-se na face inferior de cada planta uma área, que recebeu ácaros criados sobre frutos com lesões de leprose, que aí permaneceram durante sete dias. Os ácaros foram em seguida transferidos para mudas cítricas das variedades Natal e Valência e mantidos em casa de vegetação. As folhas das diferentes espécies vegetais sobre as quais os ácaros estavam anteriormente, foram destacadas e conservadas em placas de Petri, sobre algodão e papel-filtro umedecido. Ácaros criados sobre frutos sem lesões de leprose foram mantidos por três dias sobre essas folhas e, posteriormente, transferidos para novas mudas cítricas, que também foram subseqüentemente mantidas em uma casa de vegetação. Após 60 dias, quantificou-se o número de lesões de leprose nas mudas cítricas. Os resultados evidenciaram que o ácaro não perdeu a capacidade de transmissão do vírus para mudas cítricas após acesso alimentar por sete dias sobre qualquer uma das plantas intermediárias consideradas no estudo. Ácaros provenientes de frutos sem lesões de leprose adquiriram o vírus da leprose e o transmitiram a mudas cítricas quando tiveram acesso alimentar a C. benghalensis, A. conyzoides, B. pilosa, S. cordifolia e B. orellana, onde, anteriormente, ácaros criados sobre frutos com lesões de leprose permaneceram por sete dias. Estes resultados evidenciam a potencialidade de estas plantas serem depositárias e fonte de transmissão do vírus para plantas cítricas suscetíveis.

Manejo cultural do maracujazeiro-amarelo em ciclo anual visando à convivência com o vírus do endurecimento dos frutos: um estudo de caso

Este estudo de caso teve por objetivo analisar a qualidade dos frutos e a produtividade em t/ha de maracujá-amarelo, em dois ciclos anuais, plantados, respectivamente, nos dias 04-10-04 (1º plantio) e 20-08-05 (2º plantio). As mudas da seleção Afruvec foram formadas em tubetes no interior de estufa com tela antiafídeo. O pomar, nos dois ciclos produtivos, foi irrigado por gotejamento, adotando-se uma densidade de 1.600 plantas/ha. O 1º plantio foi erradicado no dia 13-07-05, em função de o pomar apresentar a totalidade das plantas com sintomas típicos do vírus do endurecimento dos frutos (PWV) nas folhas e frutos. No 1º e no 2º plantios, os sintomas tiveram início no dia 26-01-05 e no dia 04-01-06, respectivamente. Não houve necessidade de eliminação de plantas em ambos os plantios, já que o início dos sintomas de PWV ocorreu quando as plantas se encontravam em pleno florescimento. Pelos resultados, pode-se concluir que o manejo adotado regionalmente, com plantio em ciclo anual, permitiu uma ampliação do período de colheita, decorrente da antecipação de plantio no 2º ano; uma produtividade de 16,94 kg/planta e 18,39 kg/planta, no 1º e 2º anos, respectivamente; um aumento da rentabilidade na safra de 2006 em função: da maior produção, melhor cotação dos frutos para mesa e indústria, e aproveitamento dos investimentos realizados no 1º ano. As técnicas empregadas promoveram uma eficiente redução do potencial de inóculo regional, favorecendo uma sustentabilidade na produção.

Sofosbuvir and ribavirin before liver re-transplantation for graft failure due to recurrent hepatitis C: a case report.

BACKGROUND: Recurrent hepatitis C virus infection after liver transplantation is associated with reduced graft and patient survival. Re-transplantation for graft failure due to recurrent hepatitis C is controversial and not performed in all centers. CASE PRESENTATION: We describe a 54-year-old patient with hepatitis C virus genotype 1b infection and a null response to pegylated interferon-α and ribavirin who developed decompensated graft cirrhosis 6 years after a first liver transplantation. Treatment with sofosbuvir and ribavirin allowed for rapid negativation of serum HCV RNA and was well tolerated despite advanced liver and moderate renal dysfunction. Therapeutic drug monitoring did not reveal any clinically significant drug-drug interactions. Despite virological response, the patient remained severely decompensated and re-transplantation was performed after 46 days of undetectable serum HCV RNA. The patient is doing well 12 months after his second liver transplantation and remains free of hepatitis C virus. CONCLUSIONS: The use of directly acting antivirals may allow for successful liver re-transplantation for recipients who remain decompensated despite virological response and is likely to improve the outcome of liver re-transplantation for end-stage recurrent hepatitis C.

Hepatitis C virus variants resistant to macrocyclic NS3-4A inhibitors subvert IFN-β induction by efficient MAVS cleavage.

BACKGROUND & AIMS: The hepatitis C virus (HCV) NS3-4A protease is essential for the HCV life cycle and a prime target of antiviral treatment strategies. Protease inhibitors, however, are limited by emergence of resistance-associated amino acid variants (RAVs). The capacity to cleave and inactivate mitochondrial antiviral-signaling protein (MAVS) in the RIG-I-signaling pathway is a cardinal feature of NS3-4A, by which HCV blocks induction of interferon-(IFN)-β, thereby promoting viral persistence. Here, we aimed to investigate the impact of NS3-4A RAVs on MAVS cleavage. METHODS: The impact of NS3-4A RAVs on MAVS cleavage was assessed using immunoblot analyses, luciferase reporter assays and molecular dynamics simulations to study the underlying molecular principles. IFN-β was quantified in serum from patients with different NS3-4A RAVs. RESULTS: We show that macrocyclic NS3-4A RAVS with substitutions at residue D168 of the protease result in an increased capacity of NS3-4A to cleave MAVS and suppress IFN-β induction compared with a comprehensive panel of RAVs and wild type HCV. Mechanistically, we show the reconstitution of a tight network of electrostatic interactions between protease and the peptide substrate that allows much stronger binding of MAVS to D168 RAVs than to the wild-type protease. Accordingly, we could show IFN-β serum levels to be lower in patients with treatment failure due to the selection of D168 variants compared to R155 RAVs. CONCLUSIONS: Our data constitutes a proof of concept that the selection of RAVs against specific classes of direct antivirals can lead to the predominance of viral variants with possibly adverse pathogenic characteristics.

Incidência e severidade do vírus do endurecimento dos frutos em maracujazeiros enxertados em pé-franco

O objetivo deste trabalho foi avaliar a incidência e a severidade do vírus do endurecimento dos frutos em maracujazeiro-amarelo enxertado e pé-franco. O experimento foi conduzido no município de Adamantina-SP, no período de abril de 2006 a junho de 2007, adotando-se o delineamento em blocos ao acaso, com quatro tratamentos e oito repetições. Foram avaliados três porta-enxertos: Passiflora edulis, P. alata e P. gibertii, e plantas de pé-franco. Utilizou-se como copa o maracujazeiro-amarelo (Passiflora edulis Sims). Avaliaram-se a porcentagem de plantas com sintomas de virose e a severidade dos sintomas. As primeiras plantas com sintomas de virose ocorreram aos 90 dias do plantio das mudas no campo, atingindo, aos 180 dias, 100% de plantas com virose em P. alata e P. gibertii, e 97,5% em P. edulis e pé-franco.

Nouveaux traitements de l'hépatite C: aspects pharmacologiques et potentiel d'interaction [New hepatitis C treatments: pharmacological considerations and potential for drug interactions].

Progress in the understanding of the hepatitis C virus life cycle allowed the development of new, very promising antiviral therapies. Although these new drugs have a favourable profile in terms of efficacy, tolerance and interaction potential, their prescription in the setting of comedication and impaired renal or hepatic function remains a challenge. Here, we provide a summary of pharmacological considerations, focusing on sofosbuvir, simeprevir and daclatasvir. A better understanding of their metabolic pathways and transporters may help the prescriber to identify and manage drug interactions especially in patients under immunosuppressive or anti-HIV therapy. Recommendations for the prescription of these drugs in specific situations are also discussed.

Incident Hepatitis C Virus Infections in the Swiss HIV Cohort Study : changes in treatment uptake and outcomes between 1991 and 2013

Background: The hepatitis C virus (HCV) epidemic is evolving rapidly in patients infected with human immunodeficiency virus (HIV). We aimed to describe changes in treatment uptake and outcomes of incident HCV infections before and after 2006, the time-point at which major changes in HCV epidemic became apparent. Methods.  We included all adults with an incident HCV infection before June 2012 in the Swiss HIV Cohort Study, a prospective nationwide representative cohort of individuals infected with HIV. We assessed the following outcomes by time period: the proportion of patients starting an HCV therapy, the proportion of treated patients achieving a sustained virological response (SVR), and the proportion of patients with persistent HCV infection during follow-up. Results.  Of 193 patients with an HCV seroconversion, 106 were diagnosed before and 87 after January 2006. The proportion of men who have sex with men increased from 24% before to 85% after 2006 (P < .001). Hepatitis C virus treatment uptake increased from 33% before 2006 to 77% after 2006 (P < .001). Treatment was started during early infection in 22% of patients before and 91% after 2006 (P < .001). An SVR was achieved in 78% and 29% (P = .01) of patients treated during early and chronic HCV infection. The probability of having a detectable viral load 5 years after diagnosis was 0.67 (95% confidence interval [CI], 0.58-0.77) in the group diagnosed before 2006 and 0.24 (95% CI, 0.16-0.35) in the other group (P < .001). Conclusions. In recent years, increased uptake and earlier initiation of HCV therapy among patients with incident infections significantly reduced the proportion of patients with replicating HCV.