Mannose-binding lectin in chronic hepatitis C in children

Abstract

Objective. To investigate effect of mannose-binding lectin (MBL) genetic polymorphisms and phenotype in chronic hepatitis C and its impact on response to antiviral therapy in children. Methods. Fifty four children with chronic hepatitis C, aged 2.5–18 years were enrolled. Forty-five children were treated with interferon-α (IFN-α) alone (n = 2) or IFN-α and ribavirin (n = 43). Twenty-one children who responded to antiviral therapy were defined as sustained responders to therapy (IFN-SR). Before therapy, MBL genotypes and serum MBL levels (by ELISA) were determined. MBL genotype distribution and levels were correlated to disease characteristics and response to therapy. Results. Children with chronic hepatitis C who did not respond to antiviral therapy (IFN-NR) presented more frequently MBL2 polymorphisms, although this did not reach significance (p = 0.08). MBL levels were significantly lower in children classified as IFN-NR when compared to children defined as IFN-SR (1.623 ng/ml vs. 3.699 ng/ml), (p = 0.04). Serum activity levels of ALT and AST were higher in children with A/O MBL genotype when compared to group with A/A genotype (p < 0.05). Conclusions. Our findings suggest negative effect of MBL deficiency (defined by genotype and phenotype) on progression of chronic hepatitis C in children and response to antiviral therapy.

Key Words:

• genetics
• hepatitis-viral
• immunology

Acknowledgments

Contributing Pediatricians from Specialist Hepatitis out-patients Clinics in Poland: Dr Joanna Kupś, Polish Mother Memorial Hospital-Research Institute (PMMH-RI), Łódź and Dr Rokitka, John Paul II Memorial Specialist Hospital, Kraków and in the UK: Dr Vas Novelli, Great Ormond Street Hospital for Children (GOSH) NHS Trust, London and Prof. N. Klein, Department of Infectious Diseases & Microbiology, Institute of Child Health; University College London. Laboratory analysis was performed during Dr Dzwonek Marie Curie European Union Fellowship, at the Department of Infectious Diseases & Microbiology, Institute of Child Health; University College London.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.