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Impact of direct-acting antivirals on leukocytic DNA telomere length in hepatitis C virus-related hepatic cirrhosis

Demerdash, Hala M.a; Elyamany, Amany S.b; Arida, Emadc

European Journal of Gastroenterology & Hepatology: April 2019 - Volume 31 - Issue 4 - p 494–498
doi: 10.1097/MEG.0000000000001306
Original Articles: Hepatology

Background Direct-acting antiviral (DAAs) represent advancement in the management of hepatitis C virus (HCV)-related hepatic cirrhosis. A high proportion of patients achieve a sustained virologic response; eradication of HCV is coupled with a decreased risk of hepatocellular carcinoma. Recent evidence suggests that shortening of the DNA telomere may be linked to cellular senescence as well as predisposition to malignant transformation.

Objective This study aimed to assess pretreatment leukocytic DNA telomere length in HCV-related cirrhosis and post viral eradication using DAAs.

Patients and methods This study included 24 patients with HCV-related cirrhosis, Child–Pugh A. Whole-blood samples were obtained from patients before treatment and 12 weeks after the end of treatment, as well as from 24 healthy controls. Terminal restriction fragment, corresponding to telomere length, was measured using a nonradioactive Southern blot technique, detected by chemiluminescence.

Results DNA telomere length was significantly shorter before treatment compared with 12 weeks after end of treatment in HCV-related cirrhotic patients. Also, it was significantly shorter in patients before treatment compared with healthy individuals.

Conclusion Telomere elongation in blood leukocytes can be considered a marker of recovery of inflammation after DAAs-induced HCV eradication. Still, the possibility of activation by cancer initiation cannot be excluded.

Departments of aClinical Pathology, Alexandria University Hospitals

bInternal Medicine

cAnaesthesia and Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, Egypt

Correspondence to Hala M. Demerdash, MD, Department of Clinical Pathology, Alexandria University Hospitals, 75 Ismail Serry Street, Smouha-Sidi Gaber District, 21523 Alexandria, Egypt Tel: +20 122 950 1257; e-mail:

Received October 8, 2018

Accepted October 22, 2018

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