Purpose: Chronic Hepatitis C Virus (HCV)-infected patients with liver cirrhosis (LC) respond poorly to interferon-alpha (IFN-alpha) and ribavirin (RBV) combination therapy, but the reason for this is unclear. We previously reported that HCV-infection induces endoplasmic reticulum (ER) stress and autophagy response that selectively down regulates the type I IFN-alpha receptor-1 (IFNAR1) and RBV transporters (CNT1 and ENT1), leading to IFN-alpha/RBV resistance. The goal of this study is to verify whether an increase in ER stress and autophagy response is also associated with the reduced expression of IFNAR1 and RBV transporters in chronic HCV-infected patients.; Methods: Primary human hepatocytes (PHH) were infected with cell culture grown HCV particles (JFH-Delta V3-Rluc). HCV replication was confirmed by the detection of viral RNA by RT-qPCR and HCV-core protein by Western blotting. The ER stress and autophagy response and expression of IFN receptors and RBV transporters in HCV infected PHH and liver tissues derived from patients were measured by Western blotting.; Result: HCV infection of PHH showed impaired expression of IFNAR1, IFN gamma R1 (Type II IFN receptor) and RBV transporters but not IL10R beta (Type III IFN-lambda receptor). ER stress markers (BiP, IRE1 alpha and peIF2 alpha) and autophagy response (LC3II, Beclin 1 and ATG5) were induced in HCV infected chronic liver disease (CLD) and LC patients. Liver biopsies (CLD) show a 50% reduced expression of IFNAR1 and RBV transporters. Furthermore, the expression of IFNAR1 and RBV transporters was impaired in almost all LC patients.; Conclusion: HCV infection induces ER stress and autophagy response in infected PHH and chronically infected liver tissues. The expression of IFNAR1, IFNcR1 and RBV transporters were significantly impaired in CLD and cirrhotic livers. Our study provides a potential explanation for the reduced response rate of IFN-alpha and RBV combination therapy in HCV infected patients with liver cirrhosis.
