Abstract: Objective To investigate the expression and clinical significance of immunoglobulin mucin 3 (TIM-3) and programmed cell death receptor-1 (PD-1) in immune checkpoint T cells of chronic hepatitis C (CHC) patients treated with sofosbuvir/velpatasvir.Methods Between August 2020 and August 2022, 120 patients with CHC in Huai'an First Hospital Affiliated to Nanjing Medical University were selected as the CHC group, while 118 healthy individuals who underwent physical examination in the same period were selected as the healthy control group. The CHC group was treated with sofosbuvir/velpatasvir for 3 months. Blood biochemical indexes, monocyte subsets, and the levels of TIM-3 and PD-1 in each subgroup were compared between the two groups.Results In the absence of treatment, serum ALT and AST levels in CHC patients [(74.0±35.8) U/L, (55.1±26.0) U/L] were higher than those in healthy control group [(14.9±6.3) U/L, (19.2±7.0) U/L]. After three months of treatment, the PD-1 CD4, PD-1 CD8, TIM-3 CD8, TIM-3 CD4 in CHC patients [(0.6 ± 0.1) %, (1.7 ± 0.6) %, (2.5 ± 1.0) %, (6.5 ± 1.0) %, respectively] were higher than those in the healthy control group [(0.4 ± 0.1) %, (1.5 ± 0.7) %, (1.7 ± 0.8) %, (6.0 ± 2.4) %] (P<0.05).Conclusion Therapy with sophobuvir/velpatasvir can significantly improve liver function in CHC patients. The peripheral blood lymphocyte ratio is disturbed in CHC patients, and the high expression of negative immune checkpoint molecules has been observed to regulate cellular immunity. For patients who do not experience symptom improvement with single drug therapy, the addition of sofosbuvir to velpatasvir therapy may be a potential consideration.

Key words: Chronic hepatitis C, Sofosbuvir, Velpatasvir, T cell immunoglobulin mucin 3, Programmed cell death receptor-1