الفهرس 
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Abstract
HCV infection is one of the major causes of chronic liver disease worldwide. Egypt has the highest prevalence rate of HCV in the world. The genotype distribution in Egypt is mainly genotype 4 (HCV-G4) which is responsible for more than 90% of the infections, with the remaining due to HCV-G1. Cytokines play a key role in the modulation of immune responses. There are inter-individual variations in cytokines production, which may be attributed to SNPs in the DNA of these cytokines. These variations influence the balance between pro-inflammatory and anti-inflammatory cytokines, and might affect the severity as well as the the treatment outcome of HCV infection. IL-10 and IL-18 play an important role in the pathogenesis of HCV infection.
The aim of this study was to investigate the impact of IL-10 -1082 (rs1800896) and IL-18 -607 (rs1946518) gene polymorphisms on the response to combination therapy in HCV patients and to compare the genotype distributions between responders and non-responders.
This study was carried out on100 HCV patients treated by PEG-INF α2a subcutaneous injection in combination with oral RBV. An additional 100 healthy subjects were included as a control group. Patients were classified according to their response to PEG-INF plus RBV therapy into two groups: (50 SVR and 50 NR). Venous blood samples were collected from all patients and healthy controls. Genomic DNA from venous blood of subjects included in the study was extracted using the standard chemical method. SNPs at position -1082 G/A in the promoter region of the IL-10gene and at position - 607C/A in the promoter region of the IL-18 gene were genotyped using allele-specific amplification that was assessed by SYBR-green real time PCR.
Most subjects were older than 30 years old. The patients’ age range was 25-58 years (mean= 46.44) while that of the healthy controls was (mean= 40.05). Also, rural residence was more predominent than urban residence.
Significantly higher levels of the serum ALT and AST were found among HCV patients compared to the control group (P <0.05). The non-responders had significantly higher levels of pre-treatment ALT, AST and viral load. No significant difference was found between HCV patients and control group or between SVR and NR for age, sex and residence.