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The world is grappling with an escalating risk of viral outbreaks of pandemic proportion, with zoonotic RNA viruses such as chikungunya virus (CHIKV) and SARS-CoV-2 posing significant threats to global health. Several environmental and evolutionary factors have fueled the emergence and spread of infection, creating a constant arms race against emerging pathogens. Current prevention and mitigation strategies are inadequate, necessitating tools to prevent and control viral infections; innovative strategies are needed in the pipeline to address significant challenges. CHIKV is a mosquito-borne virus that has caused millions of disease cases worldwide and is a reemerging threat with increasing potential to become endemic in the US. Currently, there are no licensed treatments available to protect against CHIK disease, making the development of a vaccine crucial. Live-attenuated vaccines (LAVs) have traditionally been a promising strategy due to their high immunogenicity and cost-effectiveness. However, concerns regarding adverse side effects and the potential for viral replication leading to pathogenic reversions or transmission into mosquitoes have limited their use. To that end, we have developed a new generation of safer vaccines by modifying the standard LAV platform through innovative attenuating strategies. Our dual-attenuated platform utilizes a previously developed chimera of CHIKV and the closely related Semliki Forest virus (SFV) as a vaccine backbone which expresses antiviral mouse cytokines IFN-γ or IL-21, as an additional mechanism to control infection. In several mouse models, both cytokine-expressing candidates showed reduced footpad swelling and minimal to no systemic replication or dissemination capacity compared to the parental vaccine post-vaccination. Importantly, these candidates conferred full protection from wildtype CHIK disease. Our IFNγ-expressing vaccine showed the most significant attenuation of viral replication. To understand the underlying mechanism, we identified three IFNγ-regulated antiviral genes (Gbp1/2 and Ido1) that were highly upregulated in 3T3 mouse fibroblasts post-infection with the IFN-γ-expressing candidate but not the parental backbone. To further investigate the role of these genes in restricting viral replication and enhance the clinical relevance of our vaccine platform, we redesigned our vaccine to express human IFNγ (hIFNγ) and performed viral growth kinetics in MRC5 human lung fibroblasts. Our vaccine showed reduced viral replication compared to controls and high expression of human GBP1/2/3 was observed post-infection. Overexpression of these genes demonstrated a direct impact on viral replication against wildtype CHIKV. These findings shed light on the mechanism of action of our vaccine and highlight the potential of targeting IFNγ-regulated antiviral genes for developing effective vaccines against CHIKV. Our results provided a foundation for investigating the broad-use application of IFN-γ against other alphaviruses for vaccine or therapeutic design. We evaluated the effects of increasing levels of exogenous hIFNγ on Mayaro virus (MAYV), Ross River virus (RRV), and Venezuelan Equine Encephalitis virus (VEEV). We observed a positive dose-dependent relationship between hIFNγ and decreasing viral titers for all three viruses. Interestingly, we also observed similar patterns of GBP upregulation with MAYV and RRV, both Old World alphaviruses, but not with VEEV, a New World alphavirus. This finding may indicate an alternative IFNγ-stimulated pathway responsible for controlling different alphaviruses. Overall, these studies establish a fundamental role of IFNγ in controlling viral infection and highlight its potential use in both vaccine and therapeutic intervention. While LAVs are a gold standard for developing immunity against a virus, the urgency of responding to an active and deadly pandemic has promoted the use of faster strategies such as mRNA vaccines. Once the viral sequence was known, these vaccines were comparatively quick to produce for SARS-CoV-2 and prevented millions of disease cases at the height of their introduction. However, the emergence of variants of concerns bypassing previous immunization efforts has demonstrated the need for complementary treatments such as antivirals to control disease. To that end, we evaluated several rhodium organometallic complexes as potential antivirals against SARS-CoV-2. We show that two pentamethylcyclopentadienyl (Cp*) rhodium piano stool complexes, Cp*Rh(ICy)Cl2 and Cp*Rh(dpvm)Cl are non-toxic in Vero E6 and Calu3 cells and reduce SARS-CoV-2 plaque formation up to 99%. These complexes have previously demonstrated high antimicrobial activity against multiple antibiotic-resistance bacteria and with our results, support their potential application as pharmaceuticals, warranting further investigation into their activity. / Doctor of Philosophy / The global response to the COVID-19 pandemic, and its far-reaching impact, revealed significant shortcomings in public health preparedness for emerging viruses. Despite efforts to develop vaccines and antivirals to prevent and treat disease, current mitigation strategies have proven insufficient to eradicate the pathogen. The emergence of viral outbreaks caused by viruses such as chikungunya (CHIKV) and SARS-CoV-2 underscores the ongoing threat posed by emerging infectious diseases. Improved countermeasures are urgently needed to address gaps in vaccine and antiviral development. CHIKV is a mosquito-borne virus that has caused millions of infections across hundreds of countries with the emergent potential to become endemic in the US. Currently, there are no vaccines available to the public; therefore, it is important to generate and administer an effective vaccine before further spread of the virus. To this end, we developed innovative live-attenuated vaccines (LAVs) against CHIKV using a weakened chimeric backbone of CHIKV and its close relative, Semliki Forest virus (SFV), along with vaccine-driven expression of antiviral cytokines to control viral replication. Vaccination of highly susceptible mice with these cytokine-expressing vaccines produced significantly decreased side-effects compared to the parental virus not expressing the cytokines. Additionally, these viruses had significantly restricted viral replication capabilities while robustly protecting mice from a semi-lethal CHIKV infection. Our interferon-gamma (IFNγ) expressing vaccine had the greatest impact on viral replication, and we investigated the mechanism leading to this attenuation. To assess the clinical relevance of our vaccine platform, we redesigned the virus to express human IFNγ and identified a specific pattern of IFNγ-stimulated genes that are potentially responsible for limiting CHIKV replication. Furthermore, we demonstrated the broad therapeutic use of IFNγ against other medically relevant alphaviruses. Overall, these studies establish an improved mechanism to create safer vaccines without compromising efficacy and highlight the therapeutic potential of IFNγ against alphaviruses. Lastly, in a collaborative effort to respond to the COVID-19 pandemic, we also explored and characterized the use of a new class of antiviral drugs. With the advent of increasing drug resistance, it is essential to develop novel and resilient therapeutics. We demonstrated the first antiviral potential of rhodium organometallics, which was previously shown to be effective against multiple antibiotic-resistant bacteria. Two complexes demonstrated high virucidal activity against SARS-CoV-2 and low toxicity in mammalian cell lines. Moreover, these complexes can be further derivatized to improve efficacy, making them a promising new antiviral strategy.

Thesis (PhD (Biomedical Sciences. Molecular Biology and Human Genetics))--University of Stellenbosch, 2007. / Despite the ongoing global tuberculosis (TB) problem and extensive research into protective immunity against this intracellular pathogen, mechanisms of protective immunity against Mycobacterium tuberculosis (Mtb) in humans have not been fully clarified. Numerous reports have addressed the potential immunological defect(s) in infected individuals that have developed active TB in comparison to those who have remained healthy in spite of infection. Markers of treatment response phenotypes are still elusive. The aims of this study were to define lymphocyte subsets in the peripheral blood of TB patients and controls, to determine intracellular interferon-γ (IFN-γ) and interleukin-4 (IL-4) production and to find correlations of these data with microbiologically-defined treatment response. Methods Whole blood tests were done on 30 HIV-negative, smear-positive pulmonary TB patients and 18 healthy skin test positive volunteers resident in the same community. Immunophenotyping was performed by flow cytometry, combined with routine haematology, for the enumeration of peripheral blood immune cell subtypes. Whole blood was also stimulated in vitro with anti-CD3 monoclonal antibody and intracellular IFN-γ and IL-4 determined by flow cytometry. Lymphocyte proliferation in response to heat-killed Mtb was determined by tritiated thymidine incorporation. Routine microbiological monitoring by sputum smears and culture was done throughout the patients’ 26 weeks of treatment. Results Compared to healthy controls, absolute numbers of peripheral blood lymphocytes and lymphocyte subsets were significantly depressed in patients at diagnosis but normalized during treatment with the exception of natural killer (NK) cells and natural killer T (NKT) cells. A novel subset of the latter was found to correlate significantly with treatment response. IFN-γ-producing T cells after a 4-hour T cell receptor stimulation were significantly higher in patients at diagnosis and normalized during treatment. Supplementary kinetic experiments showed that IFN-γ production in patients at diagnosis seemed to be accelerated. Lymphocyte proliferation was lower in patients at diagnosis and normalized during treatment. Neither IFN-γ production nor lymphocyte proliferation correlated with treatment response. Low intracellular IL-4 production was constitutive in patients and controls, was insignificantly lower in patients at diagnosis than in controls and, in the slow responder patient group, it was significantly lower than in the fast responder group. High IL-4 expression was found in low numbers of T cells in patients and controls and supplementary experiments showed co-expression of active caspase-3 in these cells, which signified apoptosis. Conclusions Lymphocyte subset phenotypes associated with TB are largely abnormal only during active infection and only a novel subset of NKT cells showed correlation with treatment response. Intracellular IFN-γ production and lymphocyte proliferation is increased and decreased, respectively, only during active infection and does not correlate with treatment response. The T helper 1/T helper 2 (Th1/Th2) hypothesis could not be confirmed in the context of tuberculosis but instead constitutive IL-4 production may play a role as a growth factor.

Thesis (PhD (Molecular Biology and Human Genetics))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The growing global epidemic of human tuberculosis (TB) results in 8 million new cases of this disease and 2 million deaths annually. Control thereof will require greater insight into the biology of the causative organism, Mycobacterium tuberculosis, and into the pathogenesis of the disease. This will benefit the design of new vaccines and diagnostic assays which may reduce the degree of both disease transmission and progression. Animal models have played a vital role in the understanding of the aetiology, pathogenesis, and treatment of TB. Much of such insight has been obtained from experimental infection models, and the development of new vaccines, for example, is dependant on these. Nonetheless, studies utilising naturally occurring TB in animals, such as those which have investigated the use of interferon-gamma release assays (IGRA) for its diagnosis, have contributed substantially to the body of knowledge in this field. However, there are few such examples, and this study sought to identify and investigate naturally occuring animal TB in South Africa as an opportunity to gain further insight into this disease. During the course of this study, the dassie bacillus, a distinctly less virulent variant of M. tuberculosis, was isolated from a rock hyrax from the Western Cape Province of South Africa. This has provided new insight into the widespread occurrence of this organism in rock hyrax populations, and has given impetus to further exploring the nature of the difference in virulence between these pathogens. Also investigated was M. tuberculosis infection in dogs in contact with human TB patients. In so doing, the first reported case of canine TB in South Africa was described, v a novel canine IGRA was developed, and a high level of M. tuberculosis infection in these animals was identified. This supports human data reflecting high levels of transmission of this pathogen during the course of human disease. Additionally, the fact that infected companion animals may progress to disease and potentially act as a source of human infection was highlighted. However, an attempt to adapt a flow cytometric assay to study cell-mediated immune responses during canine TB revealed the limitations of such studies in species in which the immune system remains poorly characterised. The use of IGRAs to diagnose TB was further explored by adapting a human assay, the QuantiFERON-TB Gold (In-Tube Method), for use in non-human primates. These studies have shown that such an adaption allows for the sensitive detection of TB in baboons (Papio ursinus) and rhesus macaques (Macaca mulatta) and may be suitable for adaption for use in other species. However, they have also evidenced the limitation of this assay to specifically detect infection by M. tuberculosis. Finally, to contextualise the occurrence of the mycobacterial infections described above, and other similar examples, these have been reviewed as an opinion piece. Together, these investigations confirm that animal models will continue to make important contributions to the study of TB. More specifically, they highlight the opportunities that naturally occuring animal TB provides for the discovery of novel insights into this disease. / AFRIKAANSE OPSOMMING: Wêreldwye tuberkulose (TB) epidemie veroorsaak agt miljoen nuwe gevalle en twee miljoen sterftes jaarliks. Ingryping by die beheer hiervan vereis begrip van die biologie van die mikroörganisme Mycobacterium tuberculosis, die oorsaak van TB, asook van die patogenese van die siekte self. Hierdie kennis kan lei tot ontwerp van nuwe entstowwe en diagnostiese toetse wat gevolglik beide die oordrag- en vordering van die siekte mag bekamp. Dieremodelle speel lankal 'n rol in ons begrip van die etiologie-, patogenese- en behandeling van TB. Insig is grotendeels verkry vanaf eksperimentele infeksiemodelle, en ontwikkeling van entstowwe, onder andere, is afhanklik van soortgelyke modelle. Desnieteenstaande, studies wat natuurlike TB voorkoms in diere ondersoek, byvoorbeeld dié wat op die ontwikkeling van interferon-gamma vrystellingstoetse (IGVT) fokus, het merkwaardige bydrae gemaak tot kennis en begrip in hierdie studieveld. Daar is slegs enkele soortgelyke voorbeelde. Om hierdie rede is die huidige studie uitgevoer waarbinne natuulike diere-TB geïdentifiseer en ondersoek is in Suid-Afrika om verdere kennis en insig te win aangaande TB. Die "dassie bacillus", bekend om beduidend minder virulent te wees as M. tuberculosis, is tydens hierdie studie geïsoleer vanuit 'n klipdassie (Procavia capensis) in die Wes-Kaapse provinsie, Suid-Afrika. Insig in die wydverspreide voorkoms van hierdie organisme in klipdassie bevolkings is gevolglik verkry en verskaf momentum om die aard van verskil in virulensie tussen dié patogene te bestudeer. vii Voorts is M. tuberculosis infeksie bestudeer in honde wat in kontak is met menslike TB pasiënte en word die eerste geval van honde TB dus in Suid-Afrika beskryf. In hierdie groep diere, is 'n hoë vlak van M. tuberculosis infeksie geïdentifiseer deur gebruik te maak van 'n nuut ontwikkelde IGVT vir die diagnose van honde TB. Gevolglik ondersteun dié studie bevindinge van menslike studies wat toon dat besondere hoë vlakke van M. tuberculosis oordrag voorkom gedurende die verloop van die siekte. Verder toon die studie dat geïnfekteerde troeteldiere 'n bron van menslike infeksie kan wees. 'n Poging om 'n vloeisitometriese toets te ontwikkel om die aard van selgefundeerde immuunreaksies te bestudeer in honde met TB toon die beperkings van dergelike studies in spesies waarin die immuunsisteem gebrekkig gekarakteriseer is. Die gebruik van IGVT'e in die diagnose van TB is verder ondersoek deur 'n menslike toets (QuantiFERON-TB Gold, In-Tube Method) aan te pas vir die gebruik van nie-menslike primaat gevalle. Hierdie studies toon gevolglik dat so 'n aanpassing toepaslik is vir hoogs sensitiewe deteksie van TB in chacma bobbejane (Papio ursinus) en rhesus ape (Macaca mulatta), en mag ook aangepas word vir gebruik in ander spesies. Tog word die beperkings van hierdie toets om infeksie wat spesifiek deur M. tuberculosis veroorsaak uitgelig. Ter afsluiting word hierdie studie in konteks geplaas deur 'n oorsig te gee van bogenoemde- en soortgelyke gevalle van dierlike infeksie deur mikobakterieë in Suid-Afrika. Hierdie studies bevestig dat dieremodelle steeds belangrike toevoegings maak tydens die bestudering van TB en lig veral die moontlikhede uit dat bestudering van natuulike TB in diere kan lei tot die ontdekking van nuwe insigte ten opsigte van die siekte self.

Lawsonia intracellularis and the disease it causes in horses, equine proliferative enteropathy (EPE), is an emerging pathogen of increasing importance to the horse industry from both an economic and welfare standpoint. Long recognized as an economically important disease of swine, the hallmark of EPE is a protein-losing enteropathy, where affected horses suffer weight loss and some ultimately succumb to the disease despite aggressive treatment. There are currently no known EPE preventative measures and the epidemiology of the disease remains poorly defined. While EPE is a sporadic disease affecting less than 25% of exposed horses, some farms experience clinical cases year after year. Further, weanlings are uniquely susceptible to this disease, although no conclusive reason for this predisposition has been identified. The overall hypothesis is that the host immune response plays a significant role in the susceptibility of weanlings to L. intracellularis infection and the occurrence of clinical equine proliferative enteropathy. To test this hypothesis, four individual hypotheses were proposed: (H1) previous farm history of EPE does not have an effect on weanling seroprevalence, (H2) passively-acquired antibodies do not have an effect on susceptibility to L. intracellularis and the occurrence of EPE, (H3) the serological status of mares can be used to determine the role they play in the epidemiology of EPE on endemic farms, and (H4) L. intracellularis-specific IFN-g expression is not associated with increased resistance to EPE.

Abstract : Activation of the antigen presentation mechanisms by cancer cells is one of the main pathways used by the immune system for tumor detection and suppression. Induction of the expression of molecules of the Major Histocompatibility complex class II (MHC-II) by the interferon- (IFN) is important for the efficient presentation of tumor antigens. Nevertheless, it has been observed that expression of these molecules is supressed in tissular contexts where the concentration of estradiol (E2) is high. In this work we attempted to explain if the down-regulation exerted by estradiol on the expression of the MHC-II molecules in breast cancer cells was mediated by a silencing effect of the estrogen receptor- (ER) through a possible estrogen receptor binding site (ERBS) in the locus of promoter IV (pIV) of the master regulator of MHC-II expression, the class II transactivator (CIITA). The breast cancer cell line MDA-MB-231 (ER-/ERβ-) and its stable transfectants MC2 (ER+) and VC5 (empty vector) were used as model cell lines. Expression of the MCH-II molecules is controlled by CIITA, and stimulation with IFN activates the transcription of the pIV of CIITA. Stimulation of these cell lines with IFN induced expression of the MCH-II molecules and addition of E2 repressed such expression only in the MC2 cell line, as observed by flow cytometry analysis. Six other breast cancer cell lines were tested, with only the MCF7 cell line showing a significant inhibition. Then we analyzed if the inhibition of the MHC-II expression was due to a down-regulation of CIITA. Protein analysis performed by western blot and mRNA quantification by RT-qPCR both revealed down-regulation of CIITA in the cells exposed to IFN+E2 compared to those treated only with IFN. However, reporter gene analysis did not demonstrate any influence of our candidate ERBS in the inhibition of the activation of CIITA-pIV. ChIP-seq analysis of the VC5 and MC2 cell lines for ER also failed to demonstrate any binding of the receptor anywhere in the vicinity of the CIITA locus. However gene ontology and disease ontology analysis of the sequencing data showed a higher activation of tumorigenic cellular pathways in the cells treated with IFN + E2 than in the cells treated only with E2. These results suggest that activation of the inflammatory pathways by IFN could exert a detrimental effect on the cancer development. / Résumé : L’activation des mécanismes de présentation antigénique par les cellules cancéreuses est l’une des voies principales employées par le système immunitaire pour la détection et la suppression des tumeurs. L’induction de l’expression de molécules du complexe majeur d’histocompatibilité de classe II (CMH-II) par l’interféron- (IFN) est importante pour la présentation efficace des antigènes tumoraux. Cependant, il a été observé que l’expression de ces molécules est supprimée dans certains tissus dans lesquels la concentration d’estradiol (E2) est élevée. Dans ce travail, nous avons tenté de déterminer si l’inhibition exercée par l’estrogène (E2) sur l'expression des molécules du CMH-II dans des cellules de cancer du sein est médiée par un effet de silençage du récepteur de l’estrogène- (ER) à travers d’un possible site de liaison de récepteur d'estrogène (ERBS) dans le locus du promoteur IV du régulateur clé de l’expression du CMH-II, CIITA. La lignée cancéreuse mammaire cellulaire de cancer de sein MDA-MB-231 (ER-/ERβ-) et ses transfectants stables MC2 (ER+) et VC5 (vecteur vide) ont été utilisés comme des lignées cellulaires modèles. L'expression des molécules du CMH-II est contrôlée par CIITA, et la stimulation avec l’IFN active la transcription du pIV de CIITA. La stimulation de ces lignées cellulaires avec l’IFN induit l'expression des molécules du CMH-II et l'addition d’E2 réprime de cette expression seulement dans la lignée cellulaire MC2, telle qu'elle est observée par analyse de cytométrie de flux. Six autres lignées de cancer de sein ont été testées et seulement la lignée cellulaire MCF7 montrait une inhibition significative. Ensuite, nous avons analysé si l'inhibition de l'expression du CMH-II était due à une régulation de CIITA. L'analyse des protéines effectuée par Western blot et la quantification de l'ARNm par RT-qPCR quantitative ont révélé une inhibition de CIITA dans les cellules exposées à l’IFN + E2 par rapport à celles traitées seulement avec l’IFN. Cependant, des analyses avec un gène rapporteur n'ont pas démontré une influence quelconque de notre site de liaison de récepteur d'estrogène candidat dans l'inhibition de l'activation de CIITA-pIV. Des analyses de ChIP-seq dans les lignées cellulaires MC2 et VC5 pour l’ER n’ont également pas démontré la présence d’une liaison du récepteur dans le voisinage du locus de CIITA. Cependant, des analyses sur l'ontologie des gènes et des maladies sur les données de séquençage ont montré une activation accrue des voies cellulaires cancéreuses dans les cellules traitées avec IFN + E2 comparé avec les cellules traitées uniquement avec E2. Ces résultats suggèrent que l'activation des voies inflammatoires par l’IFN pourrait exercer un effet plus négatif qu’anticipé sur le développement du cancer. [Symboles non conformes]

As complicações hepáticas secundárias à infecção crônica pelo vírus da hepatite C (HCV) são uma importante causa de morte em portadores da infecção pelo vírus da imunodeficiência humana (HIV). Pacientes com coinfecção HIV/HCV apresentam progressão acelerada da fibrose hepática, na qual há participação da resposta inflamatória do sistema imunológico, e requerem maior atenção no tratamento da hepatite C e de suas reações adversas. Assim, os objetivos principais do estudo foram tipificar e comparar os polimorfismos -607 e -137 da interleucina-18 (IL-18), +874 do interferon gama (IFN-?? e -308 e -238 do fator de necrose tumoral alfa (TNF- ?? em quatro grupos (coinfecção HIV/HCV, monoinfecção pelo HIV, monoinfecção pelo HCV e controles saudáveis); investigar a associação dos alelos e genótipos desses polimorfismos com a resposta ao tratamento da hepatite C (respondedor e não respondedor), graus de atividade necroinflamatória (METAVIR A0A1 vs. A2A3) e de fibrose hepática (METAVIR F0-F2 vs. F3F4) em portadores do HCV e identificar os sinais e sintomas relacionados às reações adversas do tratamento da hepatite C. Os dados foram coletados nos prontuários médicos e no sistema informatizado do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto e os polimorfismos tipificados pela técnica de reação em cadeia da polimerase com iniciadores de sequência específica. Participaram do estudo 400 indivíduos, distribuídos em quatro grupos de 100, predominantemente constituídos por homens com idade média entre 33 e 50 anos. Na avaliação geral, os genótipos -238 G/G (TNF-?? e +874 A/A (IFN-?? foram mais frequentes no grupo coinfecção HIV/HCV em relação ao monoinfecção pelo HCV. O genótipo -308 G/A e o alelo -308 A (TNF-?? foram associados com a susceptibilidade à coinfecção HIV/HCV e o genótipo -308 G/G e o alelo -308 G (TNF-?), com proteção. No grupo coinfecção HIV/HCV, a frequência do genótipo - 137 G/C (IL-18) foi maior nos sujeitos com atividade necroinflamatória A0A1 que nos com A2A3. Nos pacientes com fibrose F3F4, o genótipo -238 G/G (TNF-?? foi mais frequente no grupo coinfecção HIV/HCV que no monoinfecção pelo HCV e naqueles com F0-F2, o genótipo +874 A/A (IFN-?? também foi mais frequente no grupo coinfecção HIV/HCV. A frequência do genótipo +874 T/T (IFN-??, dentre os pacientes do grupo coinfecção HIV/HCV, foi maior naqueles com fibrose F3F4 que nos com F0-F2. Não foram encontradas associações estatisticamente significantes entre as frequências alélicas e genotípicas e os tipos de resposta ao tratamento da hepatite C nos pacientes do grupo coinfecção HIV/HCV; nos do monoinfecção pelo HCV, houve diferenças nas frequências alélicas e genotípicas (posição -238 do TNF-?) entre pacientes respondedores e não respondedores. Os principais sinais e sintomas relacionados às reações adversas do tratamento da hepatite C foram mialgia, febre, fraqueza, cefaleia e hiporexia. Anemia, hiporexia e vômito foram mais frequentes no grupo coinfecção HIV/HCV. Conclui-se que há relação dos alelos e genótipos de citocinas com a gravidade da doença hepática e resposta ao tratamento da hepatite C. Adicionalmente, algumas reações adversas ao tratamento foram mais pronunciadas em coinfectados HIV/HCV / Hepatic complications secondary to chronic infection by hepatitis C virus (HCV) are a major cause of death in people infected by the human immunodeficiency virus (HIV). Patients with HIV/HCV coinfection present rapid progression of liver fibrosis, with involvement of the immune system\'s inflammatory response, and require more attention in hepatitis C treatment and its adverse reactions. The main goals of this study were to typify and compare the polymorphisms -607 and -137 of the interleukin-18 (IL-18), +874 of the interferon gamma (IFN-?? and -308 and -238 of the tumor necrosis factor-alpha (TNF-?? in four groups (HIV/HCV coinfection, HIV monoinfection, HCV monoinfection and healthy controls), to investigate the association of the alleles and genotypes of these polymorphisms with response to hepatitis C treatment (responder and non-responder), degrees of necroinflammatory activity (METAVIR A0A1 vs. A2A3) and of liver fibrosis (METAVIR F0-F2 vs. F3F4) in HCV patients and to identify the signs and symptoms related to adverse reactions of hepatitis C treatment. Data were collected on medical records and on the computerized system of the Hospital das Clínicas of the University of São Paulo Ribeirão Preto Medical School and the polymorphisms were typified using the polymerase chain reaction technique with sequence specific primers. The study included 400 individuals, distributed in four groups of 100, predominantly consisting of men with an average age between 33 and 50 years. In the overall evaluation, genotypes -238 G/G (TNF-?? and +874 A/A (IFN-?? were more frequent in the HIV/HCV coinfection group compared to HCV monoinfection. The genotype -308 G/A and allele -308 A (TNF-?? were associated with susceptibility to HIV/HCV coinfection and the genotype -308 G/G and allele -308 G (TNF-?), with protection. In the HIV/HCV coinfection group, the frequency of genotype -137 G/C (IL-18) was greater in subjects with necroinflammatory activity A0A1 than in the ones with A2A3. In patients with fibrosis F3F4, genotype -238 G/G (TNF-?? was more frequent in the HIV/HCV coinfection than in the HCV monoinfection group and in those with fibrosis F0-F2, genotype +874 A/A (IFN-?? was also more frequent in the HIV/HCV coinfection group. The frequency of genotype +874 T/T (IFN-??, among patients of the HIV/HCV coinfection group, was higher in those with fibrosis F3F4 compared to the ones with F0-F2. No statistically significant associations were found between the allele and genotype frequencies and the types of answer to hepatitis C treatment in patients of the HIV/HCV coinfection group. On the ones of the HCV monoinfection group, there were differences on the allele and genotype frequencies (position -238 of TNF-?? among responder and non-responder patients. The main signs and symptoms related to adverse reactions to hepatitis C treatment were myalgia, fever, weakness, headache and loss of appetite. Anemia, loss of appetite and vomiting were more frequent in the HIV/HCV coinfection group. It is concluded that there is relationship of the alleles and genotypes of cytokines with the severity of liver disease and response to hepatitis C treatment. Additionally, some adverse reactions to treatment were more frequent in HIV/HCV coinfected patients