HCV RNA in peripheral blood mononuclear cells (PBMCs) as a predictor of the response to antiviral therapy in chronic hepatitis C

Background: Hepatitis C virus (HCV) has been found to infect peripheral blood mononuclear cells (PBMCs), using them as a reservoir, which might contribute to the development of resistance to treatment. Objectives: To study hepatitis virus C (HCV) RNA in peripheral blood mononuclear cells (PBMCs) of patients with chronic HCV infection, and explore the relationship between the HCV RNA in the PBMCs and response to interferon (IFN) therapy. Methods: Twenty-five patients with chronic viral hepatitis C were included. The HCV RNA in PBMCs and serum was detected after 12 weeks of initializing interferon treatment, at the end of treatment, and 24 week and 1 year follow up after the end of the treatment. At the end of the treatment course, patients who were found to have positive PCR test for HCV RNA in PBMCs were subdivided into two groups, one group continues to receive IFN therapy while the other group stops. The HCV RNA in PBMCs and serum was detected by RT-PCR using the Amplicor HCV 2.0 assay. Results: All patients had negative serum PCR test for HCV RNA at the end of treatment, nevertheless HCV RNA was detected in PBMCs of approximately 32% of these patients. Patients who tested positively for HCV RNA in PBMCs at the end of treatment had an overall significantly higher relapse rate (50%) when compared with patients who tested negatively for HCV RNA in both serum and PBMCs at the end of treatment (6%). Patients with positive HCV RNA in their PBMCs who continue to receive interferon based treatment for further six months had a lower relapse rate (25%) when compared with similar patients who stopped interferon treatment at the 48th week (75%). Conclusion: Detection of HCV RNA in PBMCs may be important to assess the virological response to interferon treatment and to predict relapse after antiviral therapy and may be taken as a reference to formulate the duration of antiviral therapy in chronic hepatitis C

Hashimoto thyroiditis is an independent cardiovascular risk factor in clinically hypothyroid patients

AbstractHypothyroidism is a common disorder that confers an increased cardiovascular risk. The most common cause is Hashimoto thyroiditis (HT) but it can also be caused by thyroidectomy and radioiodine therapy. The aim of the study is to examine whether there is a relation between the cause of hypothyroidism and cardiovascular risk.Subjects and methodsThe study included 20 patients with Hashimoto thyroiditis and hypothyroidism, 20 patients with post-thyroidectomy hypothyroidism, 20 patients with post-radioiodine hypothyroidism, and 20 age and sex matched controls. In all the studied subjects we determined thyroid function tests; TSH and F.T4, thyroid auto-antibodies; anti-TPO and anti-TG antibodies, carotid intima media thickness (CIMT), flow mediated dilation (FMD) and serum nitric oxide.ResultsCIMT showed a trend to be higher in HT group (0.93±0.08mm) compared to other causes of hypothyroidism (P=0.090). Multivariate analysis showed that HT is an independent predictor of CIMT (P=0.015). FMD was significantly lower in HT group (5.74±1.33%) compared to post-thyroidectomy (7.16±1.05%) (P=0.001), and post-radioiodine therapy (7.34±1.34%) (P=0.000). Multivariate analysis showed that HT is an independent predictor of FMD (P=0.000). NO was significantly higher in hypothyroid patients (125.98±5.03μM/ml) compared to controls (39.44±3.63μM/ml) (P=0.001), both univariate and multivariate analyses showed that NO is an independent predictor of both CIMT and FMD (P=0.000).ConclusionTo our knowledge, this is the first study to show that Hashimoto thyroiditis is an independent cardiovascular risk factor in clinically hypothyroid patients

The role of matrix metalloproteinase-2 in the culture media in embryo implantation rate in normogonadotrophic cases undergoing ICSI

Objective: The aim of the study is to correlate the changes in the biochemical marker MMP-2 in the culture media with the outcome of normogonadotrophic cases undergoing ICSI. Methodology: A prospective study of infertile females was conducted in El-Shatby Maternity University Hospital between October 2011 and May 2012 utilizing a sample of 40 normogonadotrophic infertile women (22 females with unexplained infertility and 18 females with tubal factor infertility). Results: Clinical pregnancy was 57.5%; 15 out of the 22 females with unexplained infertility and 8 out of the 18 females with tubal factor infertility. There was no abortion, ectopic or chemical pregnancy. Ongoing pregnancy after 14 weeks of gestational age was 100%. Total (MMP-2) ranged between (4.1 and 21.1) and (3.5–37) ng/ml with the mean of (9.91 ± 5.48) and (13.91 ± 8.87) ng/ml for non pregnant and pregnant groups respectively. There were no statistical significant differences between the two groups regarding total MMP-2 (P = 0.055). The mean of MMP-2/embryo/h ranged between (0.05 ± 0.05) and (0.06 ± 0.08) ng/ml/embryo/h for non pregnant and pregnant groups respectively. There were no statistical significant differences between the two groups regarding MMP-2/embryo/h (P = 0.234). Conclusions: MMP-2 concentration in the culture media cannot be used as a biochemical marker for embryo selection or prediction of implantation in the normogonadotrophic cases undergoing ICSI. Recommendations: Results of the present study suggest searching for other markers in the culture media for better embryo selection and for prediction of implantation in the normogonadotrophic cases undergoing ICSI