A185 IMPACT OF HEPATITIS C ERADICATION USING DIRECT ACTING ANTIVIRALS ON CONCURRENT PRIMARY BILIARY CHOLANGITIS AND ASSOCIATED AUTOIMMUNITY.
Bibliographic record
Abstract
Chronic Hepatitis C Virus infection has been commonly linked to the development of autoimmunity, in part through activation of B cells. As well, B cells have been shown to play an important pathogenic role in Primary Biliary Cholangitis (PBC). Patients with concurrent HCV infection and PBC have an increased risk of more rapidly progressive disease, although the mechanism underlying this effect is poorly understood. However, it seemed plausible that HCV infection could enhance PBC-associated autoimmunity thereby worsening disease. Therefore, the aim of our study was to determine the impact of HCV eradication upon serological markers of autoimmunity (ie. autoantibody production) and liver biochemistry in PBC patients infected with HCV. We identified 3 HCV-infected patients who also had significant serum AMA titers, and were followed in the University of Calgary Liver Unit. All 3 patients were treated with non-interferon based direct-acting antiviral (DAA) therapies. One patient was on UDCA therapy (13 mg/kg/day) during the treatment period (elevated serum alkaline phosphatase levels). The remaining two patients were not on UDCA therapy due to intolerance in one, and normal serum alkaline phosphatase levels in the other. Virological response to DAA’s was assessed during and after therapy in all patients using a HCV Quantitative Nucleic Acid Test (Abbott), and serum liver biochemistries measured by Calgary Laboratory Services. Autoantibodies associated with autoimmune liver diseases, including PBC specifically, were measured before, during and after DAA treatment (Mitogen Advanced Diagnostics Laboratory, Calgary AB, Canada). All patients achieved a sustained virological response (SVR), as determined by a negative HCV RNA test 12 weeks post-DAA therapy. Titres of antimitochondrial antibodies (AMA-M2), anti- branched-chain 2-oxo-acid dehydrogenase complex and 2-oxo glutarate dehydrogenase complex (anti-3E-BPO), and anti- tripartite motif-containing protein 21 (TRIM21/Ro52) remained unchanged despite successful HCV eradication. Two of three patients exhibited a transient decrease in some autoantibody titres during DAA treatment, but these returned to baseline levels post-DAA therapy. Our results suggest that ongoing HCV infection is not a significant driver of PBC-related autoimmunity/autoantibody production. CIHRCal Wenzel Family Foundation Chair in Hepatology,
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".