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ObjectiveTo investigate the clinical significance of Th17/Treg imbalance and changes in associated cytokines in chronic hepatitis C (CHC) patients with liver cirrhosis. MethodsA total of 96 CHC patients who visited The First People′s Hospital of Tianmen from May 2014 to May 2016 were enrolled and divided into CHC group with 54 CHC patients, LC group with 42 CHC patients with LC, and HC group with 40 healthy persons who underwent physical examination. Flow cytometry was used to measure the percentages of Th17 and Treg cells in peripheral blood, ELISA was used to measure the serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17), and transforming growth factor-β (TGFβ), and the levels of HCV RNA, aspartate transaminase (AST), alanine aminotransferase (ALT), and total bilirubin (TBil) were also measured. An analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for comparison between any two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis was also performed. ResultsCompared with the HC group and the CHC group, the LC group had significantly higher percentages of Th17 cells (5.97%±0.84% vs 2.39%±0.46%/4.75%±0.67%, F=312.95, P＜0.001) and Treg cells (3.14%±0.72% vs 1.72%±0.53%/2.81%±0.87%, F=47.21, P＜0.001) in peripheral blood, as well as a significantly higher Th17/Treg ratio (1.90±0.52 vs 1.39±0.12/1.69±0.45, F=17.34, P＜0.001). The LC group also had significantly higher serum levels of IL-6, IL-17, IL-10, and TGF-β than the HC group and the CHC group (F=160.38, 574.11, 23.90, and 36.97, all P＜0.001). The percentages of Th17 and Treg cells, Th17/Treg ratio, and levels of IL-17, IL-6, IL-10, and TGF-β were significantly positively correlated with ALT and AST levels (ALT: r=0.633, 0.525, 0.631, 0.931, 0.841, 0.372, and 0.343, all P＜0.05; AST: r=0.597, 0.502, 0.564, 0.873, 0.813, 0.365, and 0.337, all P＜0.05), and the percentages of Th17 and Treg cells and levels of IL-6, IL-17, and TGFβ were also significantly positively correlated with TBil level (r=0.344, 0.231, 0.401, 0.339, and 0.307, all P＜0.05). ConclusionTh17 and Treg cells and associated cytokines may be closely associated with the development and progression of CHC and LC and have certain significance in the prevention and treatment of CHC patients with LC. [ABSTRACT FROM AUTHOR]

Objective To investigate the change in peripheral blood CD4+ regulatory T (Treg) cells and its association with antiviral effect in patients with chronic hepatitis C (CHC). Methods A total of 85 CHC patients who completed standard antiviral therapy and follow-up in The First People's Hospital of Tianmen from January 2013 to January 2016 were enrolled as CHC group, and 40 healthy volunteers were enrolled as control group. Flow cytometry was used to measure peripheral blood CD4+ Treg cells, and the serum levels of HCV RNA, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were measured before treatment, at 12 and 48 weeks of treatment, and at 24 weeks of follow - up. The t-test was used for comparison of continuous data between groups. Results Before treatment, the CHC group had significantly higher levels of HCV RNA, AST, ALT, and CD4+ Treg cells than the control group (all P < 0.001). At 12 weeks of treatment, of all patients in the CHC group, 36 (42.35%) achieved early virological response (EVR) (EVR group) and 49 (57.65%) did not achieve EVR (no - EVR group); the EVR group had significant reductions in the levels of HCV RNA and CD4+ Treg cells after treatment (t = 39.241 and 8.763. both P < 0.001), and there were significant differences in the levels of HCV RNA and CD4+ Treg cells between the two groups (t=76. 520 and 8. 227. both P < 0. 001). At 48 weeks of treatment, of all patients in the CHC group. 49 (57.65%) achieved end-of-treatment response (ETR) (ETR group) and 36 (42.35%) did not achieve ETR (no - ETR group); the ETR group had significant reductions in the levels of AST, ALT, CD4+ Treg cells, and HCV RNA at 48 weeks of treatment (t=46.197, 11.806, 15.368, and 9.694, all P<0.001) and had significantly lower levels than the no-ETR group (t=72.612, 9.274, 9.682, and 7.729, all P <0.001). At 24 weeks of follow - up, of all patients in the CHC group, 39 (45.88%) achieved sustained virologieal response (SVR) (SVR group), among whom 30 achieved EVR and 32 achieved ETR, and 46 (54.12%) did not achieve SVR (no - SVR group); at 48 weeks of treatment and 24 weeks of follow - up, the SVR group had significantly lower levels of HCV RNA, AST, AIT, and CD4+ Treg cells than the no - SVR group (at 48 weeks of treatment: t = 117, 564, 17.113, 10.564, and 4.452, all P < 0.001; at 24 weeks of follow-up: t=11.196, 20.997, 13.384, and 7.900, all P<0.001). Conclusion CHC patients have an increase in peripheral blood CD4+ Treg cells and antiviral therapy can effectively reduce the level of CD4+ Treg cells and alleviate liver injury. Measurement of peripheral blood CD4+ Treg cells can be used as an assessment index for the development of CHC and the effect of antiviral therapy. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of different laboratory test reagents for hepatitis C virus (HCV) antibody through a comparative analysis. Methods A total of 207 samples which tested positive by four anti-HCV screening reagents commonly used in the laboratories in China (Kehua, Xinchuang, Wantai, and Abbott) were included. HCV RNA nucleic acid amplification (NAT) was performed, and if NAT results were negative, recombinant immunoblot assay (RIBA) was performed for further confirmation. The test results of these four screening reagents were compared, and their S/CO values and true positive rates were analyzed. Results Of all the 205 samples testing positive by any one reagent, 191 (93.2%) tested positive by the four reagents, and 14 (6.8%) were tested inconsistently by the four reagents. The positive predictive values of Xinchuang, Kehua, Wantai, and Abbott reagents were 88.2% (180/204), 93.8% (180/192), 91.4% (180/197), and 90.0% (180/200), respectively. The S/CO thresholds with a positive predictive value of ≥95% for Xinchuang, Kehua, Wantai, and Abbott reagents were 9.0, 4.0, 5.0, and 7.0, respectively. Conclusion Xinchuang, Kehua, Wantai, and Abbott reagents have significantly different S/CO thresholds with a positive predictive value of ≥95%, which are significantly different from those in other domestic laboratories. Each laboratory should establish an applicable S/CO threshold with a positive predictive value of ≥95%, in order to reduce the sample size for confirmatory test. [ABSTRACT FROM AUTHOR]