CD86/Programmed Death-Ligand-1 as a Predictor Ratio for Response to Directly Acting Antiviral Therapy of Chronic Hepatitis in Egyptian Patients

Objectives: Predictors of direct-acting antivirals response of HCV serve as assessment methods and help to treat doctors identify patients who are likely or unlikely to SVR. Methods: : Egyptian chronic hepatitis C patients (N=300) were divided into 2 groups with 150 patients each. Group 1: received triple therapy (Sofosbuvir, Pegylated interferon, and ribavirin) for 12 weeks. Group 2: received dual therapy (Sofosbuvir and ribavirin) for 24 weeks. For all patients, routine blood markers, extracellular matrix markers, and dendritic cell markers were done. Hyaluronic acid, Collagen IV, Procollagen III peptide, laminin, platelet-derived growth factor and tissue inhibitor of metalloproteinase-1, were all performed using ELISA. Dendritic cells Co-stimulatory markers (CD40, CD83, and CD86), and co-inhibitory marker (PD-L1) were evaluated by real-time PCR. Results: : SVR is associated with a decrease in the extracellular matrix markers and dendritic cell markers. AST/ALT (p= 0.003), Fibroscan (p= 0.024), CDs co-stimulatory markers and PD-L1 (p= 0.05-p< 0.0001) were differentiated between responders and non-responders. Using multivariate analysis exhibited that the decrease in PDL1 levels was significant (p=0.012) and increase significant (p= 0.024) in CD86 associated with SVR. CD 86/ PDL-1 ratio had an AUC of 0.82 for prediction SVR. Conclusions: : Baseline CD 86/ PDL-1 ratio was the only marker predicting SVR.