الفهرس 
review of literatureOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
Summary and Conclusion
Chronic hepatitis C virus (HCV) infection is a significant clinical problem
throughout the world. . About 85% of people infected with HCV develop chronic
infection, and approximately 70% of patients develop histological evidence of
chronic liver disease.
Egypt has the largest epidemic of hepatitis C virus (HCV) in the world. The
overall prevalence (percentage of people) positive for antibody to HCV was
14.7%.
At present, the standard treatment for chronic HCV infection is 48 weeks
with a combination of pegylated interferon alfa-2a or alfa-2b plus ribavirin.
However, about 60% of patients with high-titer HCV genotype 1 infections remain
non responsive to combination therapy.
The aim of this study is to determine correlation between serum interleukin -
8 levels in patients with chronic hepatitis C viral infection and response to
pegylated Interferon /Ribaverin after 24 weeks of therapy.
A total of 50 healthy controls and 50 patients with chronic HCV infection
were enrolled in this study. About half of the studied patients were males (62%)
and (38%) were females. Most of the studied patients were from rural areas
(70%).
Each patient in the current study was subjected to the following: history
taking, laboratory investigations, liver histology, and estimation of serum
interleukin-8 levels in patients before beginning treatment. Patients then have been
followed up for 24 weeks after initiation of therapy to determine response to
interferon therapy by mearuring the viral load.
Then the results of the current study were calculated and statistically
analyzed.
In the present study, serum IL-8 was higher in patients of chronic hepatitis C
than controls (p<0.001).
At the end of 24 weeks of interferon/ribavirin therapy in current study, PCR
showed that 88% of the studied patients have virological response with negative
PCR, while 12% were non-responders.
Non-responders were found to have non-significant higher pretreatment
interleukin-8 levels than responders with mean IL-8 347±421.3 pg/ml versus
41.8±145.5pg/ml, respectively.
Baseline laboratory assessment showed that responders were found to have
better liver enzymes (ALT, 50.7 U/l versus 61 U/l in non-responders; AST, 45.8
U/l versus 51.8 U/l in non-responders) and lower quantitative viral load (100.6*103
versus 205.6*103 in non responders).
It was noted that there is a significant weak negative correlation between
response to treatment and degree of fibrosis (r=-0.3, p= 0.03).
There was, in addition, a moderate negative correlation between response to
treatment and each of Interleukin-8 (r = -0.5, p=0.001) and total bilirubin (r = -0.5,
p=0.001) and there was a significant difference (p=0.001) between responders and
non-responders regarding their total bilirubin.
Current study showed that there is a high percentage of non-responders who
have positive anti-Schistosomal anti-body test.
In conclusion this study showed that serum levels of the pro-inflammatory
chemokine IL-8 in patients with chronic hepatitis C are significantly higher in
comparison with healthy controls. IL-8, in addition was predictor for response to
interferon/ribavirin therapy in the studied chronic HCV patients. Responders are
tend to have lower pretreatment serum levels of IL-8 than non-responders. The low
fibrosis stage and low viral load are associated with response to therapy.