Hepatitis C with and without dermatological manifestations: comparison of human leukocyte antigen-DR types, circulating T-cell subsets, and relation to disease severity

Background The host’s interaction between T lymphocytes and human leukocyte antigen (HLA) could affect the progression of hepatitis C virus (HCV) infection and contribute to the factors affecting disease outcome. The relation of HLA types and circulating T-cell subsets to hepatitis severity in patients with and without dermatological manifestations was not evaluated earlier. Objective To compare patients infected with HCV with and without dermatological manifestations with regard to HLA-DR genotypes, circulating T-lymphocyte subsets, and relation to hepatitis severity. Patients and methods Forty patients having HCV infection (20 with and 20 without dermatological manifestations, groups A and B, respectively) were evaluated for the percentage of circulating T-lymphocyte subsets (CD4+ , CD8+ , and CD56+ ) using flow cytometry, HLA-DR types, and the Child-Pugh classification of their liver cirrhosis. Results Group A compared with group B showed higher rates of Child-Pugh class C (70 vs. 55%) but the difference did not reach a significant level. The percentage of CD8 + T cells were significantly lower in group A than B (27.98± 9.48% vs. 34.65± 8.61%, respectively, P 0.05) with no significant difference regarding the percentage of circulating CD4 + and CD56+ cells. HLA-DR3 and HLA-DR4 were less frequent in group A than B. HLA-DR7, HLA-DR2, HLA-DR51, and HLA-DR52 were all positive in group A and negative in group B. Conclusion Immunogenetic host factors associated with the development of skin manifestations in patients with chronic HCV infection may be important in evaluating such patients as they are also related to high-grade liver cirrhosis.