الفهرس 
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Abstract
Hepatitis C is a major public health problem and a leading cause of chronic liver disease. Hepatitis C is caused by infection with the hepatitis C virus (HCV), an enveloped, single stranded, positive sense RNA virus. HCV has chronically infected 2-3% [130–170 million people] of the world’s population.
Chronic hepatitis C is inflammation of the liver that continues without improvement for ≥ 6 months. Chronic hepatitis is not a single disease, but rather a complex clinico-pathological syndrome with multiple causes, varying stages of necro-inflammatory and sclerosing liver damage, different prognoses and responses to treatment.
IL-10, plays a critical role in regulation of immune responses in health and immune mediated disease. Both IL-10 deficiency and overproduction may be responsible for some lesions. Too low production levels of this cytokine may result in an increase of inflammatory reactions, which may result in some autoimmune disorders. In turn, overproduction may result in increased susceptibility to viral infections or cancer.
Serum levels of interleukin-10 (IL-10) were found to be elevated in a proportion of patients with untreated chronic hepatitis C, and this may compromise the host immune response to the virus. The capacity for IL-10 production varies according to the genetic composition of the IL-10 locus. Likewise, it has been stated that IL-10 levels differ widely between individuals, possibly because of polymorphisms in the promoter region of the IL-10 gene. A number of polymorphisms have appeared to control the level of secretion of this cytokine. There are three single nucleotide polymorphisms (SNPs) at positions-1082, -819 and -592 with respect to the transcription initiation site.
The aim of the present work was to detect the prevalence of IL-10 gene promoter polymorphism (IL10-1082G/A) among HCV patients (responders and non-responders) to 12 weeks’ combination therapy (pegylated interferon-α with ribavirin) using 5’ Nuclease assay.
This study was carried out on Fifty chronic hepatitis C patients after 12 weeks of combination therapy; pegylated interferon-α with ribavirinand all the patients were treatment naive. Patients were diagnosed in the department of Tropical Medicine in Alexandria University Hospital and then were referred to Shark El-Madina Hospital for treatment , Patients were further subdivided:
Group I: The responders, were identified by clearence of viremia after 12 weeks of treatment
Group II: The non-responders, were identified by persistance of viremia after 12 weeks of treatment.
The previous 2 groups were compared to each other.
The exclusion criteria included:
1. Patients with hepatitis B virus infection.
2. Patients with metabolic disorders.
3. Patients with HIV disease.
4. Patients with diabetes mellitus.
5. Patients with auto-immune hepatitis.
6. Patients with previous history of hepatitis treatment.
Patients were evaluated by full detailed medical history, many laboratory investigations including: routine investigations of chronic hepatitis C; complete blood picture, routine liver function test as serum total bilirubin, ALT AST, ALP; also renal function test as regards creatinine and HCV antibody detection .
The 2 groups were subjected to HCV-RNA viral load. IL-10 (-1082) polymorphism was measured by 5’Nuclease assay. The results of this study showed the following:
• Comparative Studies
Regarding the risk factors, the incidence of IL-10 (-1082) gene promoter polymorphism in our study showed no significant difference in the HCV responder group compared to the non-responder HCV group.
In the present study, an important predictor of treatment response; liver fibrosis, was compared between the different groups; revealed that, its F3 was significantly higher in HCV non-responder group compared to the HCV responder group. F1 was significantly higher in HCV responder group compared to the HCV non-responder group.
Regarding the routine investigations of HCV, the serum α feto-protein level was significantly higher in non-responder group compared to responder group.
On comparing the different groups regarding the WBC count, hemoglobin level and platelet count, their levels before and after 12 weeks of treatment showed significant difference in responder and non-responder groups.