Abstract: Objective The purpose of this study was to investigate the changes and clinical implications of serum NoD-like receptor heat protein domain associated protein 3 (NLRP3), and its downstream interleukin 1β(IL-1β)and IL-18 (IL) levels in patients with chronic hepatitis C (CHC) undergoing sorfosbuvir/daratavir antiviral treatment. Methods 104 patients with CHC were enrolled in to our hospital between March 2018 and March 2022, and all were treated with sorfosbuvir/daratavir for 12 weeks. After discontinuation of the regimen, all patients were followed-up for 24 weeks. Serum NLRP3, IL-1β and IL-18 levels were detected by ELISA. Results At the end of the 12-week antiviral treatment, serum NLRP3,IL-1β and IL-18 levels in 104 patients with CHC were (713.5±136.7)pg/ml,(2.8±1.0)pg/ml and (644.3±130.8)pg/ml, all significantly decreased as compared to [(1137.1±172.8)pg/ml, (4.9±1.1)pg/ml and (1027.2±202.1)pg/ml, respectively, P＜0.05] at presentation; at the end of the 12-week antiviral treatment, serum NLRP3,IL-1β and IL-18 levels in 31 patients with low serum viremia at admission were(638.3±122.6)pg/ml, (2.5±0.6)pg/ml and (538.9±111.8)pg/ml, significantly lower than [(708.4±130.1)pg/ml, (2.8±0.9)pg/ml and (629.2±123.5)pg/ml, respectively, P＜0.05] in 44 patients with moderate serum viremia or [(802.5±137.0)pg/ml, (3.3±0.8)pg/ml and (801.3±140.8)pg/ml, respectively, P＜0.05] in 29 patients with high serum viremia; in our series, the early virologic response (VR) rate, end treatment of virologic response rate and sustained virologic response rate were 71.1%, 90.4% and 87.5%, after antiviral treatment, and serum NLRP3, IL-1β and IL-18 levels in patients with VR at any observation time were all significantly lower than in those without VR (P＜0.05). Conclusion The abnormal elevation of serum NLRP3 and its downstream cytokine levels in patients with CHC might be related to the hepatic pathogenesis and response to antiviral therapy, and we recommend to monitorthe changes of them during antiviral treatment, which might be helpful to predict the antiviral efficacy.

Key words: Hepatitis C, Sofobuvir, Daratavir, Nod-like receptor heat protein domain associated protein 3, Virologic response, Therapy