ABSTRACT
Hepatitis C virus [HCV] is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma worldwide. A strong Thl response seems to be associated with viral clearance. It is generally accepted that T cell activation is characterized by the synthesis and secretion of interleukin-2 and by the expression of Interleukin-2 receptors [IL-2R] on the cell surface of immune cells. The aim of this study is to determine the evolution of soluble IL-2 receptors [sIL2-R], as an indicator of activation of T cells in HCV patients treated with ribavirin and pegylated interferon and its correlation with outcome of therapy. 53 naive [previously not treated] chronic HCV patients eligible for criteria of therapy according to the international guidelines were recruited. Pegylated interferon alpha-2a [IFNalpha-2a] was used subcutaneously once a week for 48 weeks. Ribavirin tablets in a dose of 13mg/kg were given daily in 2 divided doses Liver function and complete blood picture were monitored weekly for the first month and then monthly in the course of administration of therapy. HCV-RNA was monitored every 3 month. Sera were collected at different time point before and during therapy and tested for level of soluble IL2-R using ELISA techniques. Prior to therapy, mean serum soluble IL-2R level was significantly higher in patients with HCV as compared to controls [3709.05 +/- 291.4 pg/ml versus 1770.6 pg/ml +/- 220.3, p<0.01]. After end of therapy, patients were retrospectively classified into 2 groups, responders and non-responders. In responders, the level of sIL-2R raised significantly after 4 weeks of therapy as compared to pre-treatment level [4501 +/- 309 pg/ml versus 3550 +/- 291 pg/ml p= 0.01]. In non-responders, however, the difference in serum sIL2R before therapy and after 4 weeks of therapy was non-significant [4021 +/- 567 pg/ml versus 3934 +/- 550 pg/ml p=0.9]. The levels of serum sIL2-R significantly correlated in a linear model with ALT levels before starting the therapy. Monitoring of sIL-2R levels may therefore be of value as an adjunct to the measurement of serum ALT and HCV-RNA in predicting the response to interferon therapy in HCV patients
Subject(s)
Humans , Male , Female , Interferon-alpha , Ribavirin , Prognosis , Receptors, Interleukin-2/bloodABSTRACT
Helicobacter pylori [H.pylori] is a major causative agent of chronic gastritis and peptic ulcer disease. Furthermore, H.pylori plays an important role in the pathogenesis of gastric cancer and gastric mucosa-associated lymphoid tissue [MALT] lymphoma. So the accurate diagnosis of the H.pylori infection is of clinical importance to compare the accuracy of four tests, including culture, histopathology, rapid urease test and serology for the diagnosis of H.pylori infection in patients with dyspepsia. National Hepatology and Tropical Medicine Research Institute. Prospective study. Sixty patients complaining of dyspepsia and undergoing upper endoscopy were included in the study, three antrum biopsy specimens were taken from each patient for rapid urease test, histopathological examination and culture. Blood samples were taken after endoscopic examination and sera were separated by centrifugation and stored at -70C until analyzed. A total of 60 patients were included in this study, 24 males and 36 females. Their age ranged from 23-65 years, histopathology was positive in 45 patients [75%]. Rapid urease test was positive in 36 patients [60%]. Culture was positive in 24 patients [40%] and Serology was positive in 45 patients [75%]. We found that If endoscopy was to be performed, a biopsy urease test was recommended as the test of first choice, with histology recommended only in negative cases. Culture is recommended in treatment-resistant cases to allow testing for antibiotic susceptibility. If endoscopy is not to be performed, serology is also an accurate test, but coupling it with testing of virulence strains is preferred to avoid unnecessary treatment