Plasma apolipoprotein H limits HCV replication and associates with response to NS3 protease inhibitors-based therapy

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Sultanik, Philippe | Mallet, Vincent | Lagaye, Sylvie | Casrouge, Armanda | Dorival, Céline | Barthe, Yoann | Fontaine, Hélène | Hézode, Christophe | Mottez, Estelle | Bronowicki, Jean-Pierre | Carrat, Fabrice | Theodorou, Ioannis | Abel, Laurent | Gayat, Etienne | Fontanet, Arnaud | Pol, Stanislas | Albert, Matthew L.

Edité par CCSD ; Wiley-Blackwell -

International audience. BACKGROUND & AIMS:Chronic infection with HCV remains a public health problem with approximately 150 million people infected worldwide. HCV intersects with lipid metabolism for replication and entry; and plasma concentrations of apolipoproteins have been identified as predictors for response to therapy. Herein, we conducted a screen of plasma proteins, including all apolipoproteins, to identify correlates of response to pegylated-interferon/ribavirin (PR) and HCV non-structural protein 3 (NS3) inhibitors (i.e., telaprevir/boceprevir) therapy in treatment-experienced cirrhotic patients from the ANRS CUPIC cohort.METHODS:We analysed 220 baseline plasma protein concentrations in 189 patients using Luminex technology and analyzed results.RESULTS:We identified baseline levels of apolipoprotein H (apoH) as a surrogate marker for sustained virological response (SVR). Notably, increased plasma concentration of apoH, used in combination with known clinical parameters, established a robust model with improved classification of patients as likely to achieve SVR (AUC = 0.77, Se = 66%, Sp = 72%, NRI = 39%). Moreover, we provide mechanistic information that indicates a previously unidentified role for apoH during viral entry. Using a human liver slices HCV infection model, we demonstrate that apoH limits replication.CONCLUSION:These data support testing of new biomarker strategies for the management of cirrhotic HCV patients and expand our understanding of how apoH may intersect with HCV infection

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