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. 2002 Jan;127(1):131-6.
doi: 10.1046/j.1365-2249.2002.01729.x.

Complement C4 monitoring in the follow-up of chronic hepatitis C treatment

C Dumestre-Perard  1 , D Ponard, C Drouet, V Leroy, J-P Zarski, N Dutertre, M G Colomb
Affiliations

Complement C4 monitoring in the follow-up of chronic hepatitis C treatment

C Dumestre-Perard et al. Clin Exp Immunol. 2002 Jan.

Abstract

The overall role of complement in the host--pathogen relationship is now well understood. However, its involvement at a chronic stage of infection, such as chronic hepatitis C, is less well documented. Here, results are reported which point to the use of specific C4 monitoring in the follow-up of HCV patients. This study concerns 66 patients with chronic HCV infection, treated with interferon alpha 2b alone or with interferon alpha 2b + ribavirin, and 50 healthy adults as controls. Complement blood tests were performed to measure C1q, C3, C4, mannan binding lectin (MBL), C1s-C1 inhibitor complexes, total (CH50) and C4 (C4H) haemolytic activity; specific C4 activity was taken as the C4H/C4 protein ratio. Rheumatoid factor (RF) levels were also measured. A significant reduction in CH50 and specific C4 activity in HCV patients, compared with the healthy controls, was observed before the onset of treatment; the other parameters were not affected and no C1s-C1 inhibitor complexes were detected. At the same time, a significant reduction in specific C4 activity was observed in relapsers compared with sustained responders. These results point to a potential predictive function of C4 specific activity to monitor the response to therapy. Restoration of specific C4 activity at 6 months was better in responders than in non-responders. Complement activation in chronic hepatitis C does not seem to involve the C1 stage of the classical pathway. A negative correlation between specific C4 activity and RF titres suggests a possible involvement of RF in C4 activation, via the lectin pathway. Specific C4 monitoring appears to be a valuable tool for the follow-up of chronic hepatitis C treatment, together with the other conventional investigations.

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Figures

Fig. 1
Fig. 1
Correlation between specific C4 and rheumatoid factor (RF) in patients with hepatitis C before therapy. Specific C4 and RF titres were determined as described in Material and Methods. Correlation coefficients between variables and statistical significance of the associations were determined with Spearman rank order correlation analyses.
Fig. 2
Fig. 2
Specific C4 in patients before (M0), after 3 months (M3) and after 6 months (M6) of therapy. Specific C4 was determined according to Material and Methods. The shaded bar corresponds to the mean and vertical lines correspond to the standard deviation. Statistical significance between groups was determined by the Wilcoxon test. (a) Responder group (n =28); (b) non-responder group (n =20).
Fig. 3
Fig. 3
Follow-up of specific C4 in sustained responder and relapser groups during 12 months of therapy. Specific C4 was determined as described in Material and Methods.
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