ABSTRACT
Tumour necrosis factor alpha [TNF-alpha] and interferon gamma [INF-gamma] are cytokines involved in natural immune responses and are important in antiviral modulation. INF-gamma is an immunostimulatory or growth-promoting factor that activates the macrophages and natural killer [NK] cells, while plasma TNF- alpha is a proinflammatory cytokine that participates with interleukine -1 [IL-1] and interleukine - 6 [IL-6] in the acute phase response and synergizes to mediate inflammation, shock and death. The World Health Organization has now recognized hepatitis C virus [HCV] as a major public health problem. The present study was conducted to assess the level of endogenous interferon [IFN-gamma] and tumor necrosis factor [TNF- alpha] to evaluate the immunological changes occurring among patients with HCV, and to study the relation of hypoalbuminemia and liver cirrhosis to plasma TNF-alpha and INF-gamma, in order to implement a nutritional care program appropriate for every patient according to his health status. The study was conducted on 2 groups of individuals. Group I comprised 40 patients infected with HCV, not treated with any antiviral medication, while group 2 comprised 20 healthy individuals who served as controls. Both groups were subjected to clinical examination, assessment of nutritional status and laboratory investigations including complete blood picture [CBC], liver function tests, plasma TNF- alpha, and IFN-gamma estimation. A significant increase in serum alanine transferase [s. ALT], Gamma giutamyl transferase [s. GGT], serum bilirubin [s. bil.], plasma INF -gamma and plasma TNF- alpha at P= 0.00. Meanwhile the levels of prothrombin activity, platelet count and s. albumin [s. aib] demonstrate a significant reduction at P= 0.00 when cirrhotic and non-cirrhotic HCV patients with or without hypoalbuminemia wee compared to controls. An inverse significant correlation was found between s. bilirubin level and plasma INF -gamma among cirrhotic patients, and between s. bilirubin level and plasma TN F- alpha, but a positive association between plasma TNF- alpha and s. alb and WBC count was found among patients with hypoaibuminemia. However, no significant correlation was detected between serum albumin and plasma TNF- alpha and plasma INF -gamma among cirrhotic or non-cirrhotic patients at P<0.00. Hypoalbuminemia and liver cirrhosis could probably affect the antiviral modular activity of plasma TNF- alpha and endogenous IFN-gamma among HCV patients