Circulating apolipoprotein alpha1, haptoglobin and alpha2 macroglobulin as fibrosis markers in chronic hepatitis c patients

Hepatitis C virus [HCV] infection is one of the commonest chronic liver diseases worldwide. Progression to chronic disease occurs in the majority of HCV infected patients. The aim of the present work was to study serum levels of alpha2 macroglobulin [alpha2-MG], Apolipoprotein A1 [Apo-1] and Haptoglobin [HP] as non-invasive index of the presence of cirrhosis in chronic hepatitis C patients in relation to the histopathological findings. The study was carried out on 20 patients with chronic HCV and liver cirrhosis [Group I], 20 patients with chronic HCV without liver cirrhosis [Group II] and 10 healthy subjects of mathing age and sex as controls [Group III]. Quantitative estimation of alpha2-MG, HP and Apo AI in serum was done using turbidimetry. The mean serum level of alpha2-MG was significantly higher in group I than in groups II, III [F=12.8] [p=0.00]. On the other hand, Serum Apo A1 and HP were significantly lower in group I than in groups II, III [F=5.9 and 26.3] [p=0.005 and 0.00]. On the other hand, no significant difference was found between groups II and III. Significant positive correlation was observed between serum alpha2-macroglobulin and Child Pugh score, Grading and staging of liver pathology [P<0.05]. On the other hand, significant negative correlation was noticed between serum Apo-1, HP and Child Pugh score, histopathological grading and staging [P<0.05]. Elevated serum levels of alpha2 macroglobulin in addition to low levels of apolipoprotein A1 and haptoglobin might be considered as valuable non invasive parameters for predicting the occurrence of cirrhosis in chronic hepatitis C patients

Clinical significance of plasma homocysteine concentration in chronic hepatitis C patients with liver cirrhosis

Homocysteine [Hcy] is a sulfur containing amino acid that is formed as an intermediate in methionine metabolism. Extensive evidence shows that hyperhomocysteinemia is considered an independent risk factor for atherothrombotic vascular disease. Methionine metabolism occurs mostly in the liver. Altered methionine metabolism, in advanced liver disease, may play a pathogenic role. The aim of this work was to evaluate the clinical significance of plasma Hcy concentration in chronic hepatitis C patients with liver cirrhosis. Twenty male patients [mean age 43.13 +/- 7.02 year] with chronic hepatitis C with liver cirrhosis [Group I] and 10 healthy age-matched control subjects [Group II] were included into the study. Ten patients with liver cirrhosis were diagnosed with hepatorenal syndrome [HRS] [Group Ia] and 10 did not have FIRS, Liver function, renal function tests, urinalysis, HCV Ab, HCV-PCR, plasma folate, B12 and Hcy concentration, abdominal ultrasound were performed for all studied subjects. Plasma Hcy concentration was significantly elevated in cirrhotic patients compared to healthy controls [P<0.05]. Hcy was positively correlated with the severity of liver disease as expressed by the Child score [P<0.05]. Plasma Hcy concentration was significantly higher in patients with HRS than in patients without HRS [P<0.05], and inversely correlated with the creatinine clearance rate [P<0.05]. There was no significant difference in folate and B12 levels between patients and controls. Plasma Hcy is elevated in patients with chronic hepatitis C and liver cirrhosis, and correlated with the progression of liver disease, Patients with cirrhosis complicated with HRS have higher Hcy concentration compared to patients with normal renal functions, and Hcy level increases with the deterioration of renal function

Serum soluble transferrin receptors in patients with chronic hepatitis C

Recently, it has been found that iron is an important element in the natural history of hepatitis C. Serum markers of iron stores are frequently increased in chronic hepatitis C infected patients and therefore, detection of soluble transferrin receptor[sTfR] may allows for quantitative evaluation of intracellular iron. The aim of the present study was to study serum levels of soluble transferrin receptors in patients with chronic HCV. The study was carried out on 40 patients classified into three groups. Group I enrolled 10 chronic HCV with high serum iron and ferritin, Group II included 10 patients with chronic HCV with normal serum iron and ferritin [Both groups I, and II had no cirrhosis], Group III compromised of2O patients with chronic HCV and liver cirrhosis. Also 10 healthy subjects were taken as control. Soluble transferrin receptors were measured in patient sera using humans TJJ? ELISA Kit. The mean serum sTfR was significantly lower in group III than in groups I, II and IV. Also, it was significantly lower in group I than in groups II and IV On the other hand, no significant difference was found between groups II and IV. Correlation study revealed significant negative correlation between serum sTfR and serum iron and ferritin in groups L II and III. Moreover, in group III significant negative correlation was noticed between serum sTfR and staging [r0.83, 0.00]. sTfR can be regarded as a valuable and specific tool for investigating tissue iron that can be used to predict the degree of hepatocellular damage and progression into advanced fibrosis and subsequent cirrhosis

Study of the serum level of Interleukin-IS (IL-18) in patients with chronic hepatitis C virus infection

Background: One of the most important factors affecting HCV pathogenesis are cytokines. Up till now most of the researches revealed enhanced hepatic expression of the Th1 cytokines in individuals with chronic HCV. However this is not enough to explain the pathogenesis of HCV. Therefore, studying of more advanced mechanisms of recently discovered cytokines may be helpful in solving this problem

Objective: The aim of the present work was to study the serum level of IL-18 in patients with chronic hepatitis C. Virus infection with and without liver cirrhosis and in hepatocellular carcinoma

Methods: The study was conducted on fifty subjects classified into four groups Group I: included twenty patients with chronic HCV virus infection without liver cirrhosis. Group II: enrolled ten patients with chronic HC V virus infection with liver cirrhosis. Group III: compromised of ten patients with hepatocellular carcinoma on top of chronic HCV, Group IV: ten healthy subjects with matching age and sex were enrolled as controls. IL-18 was measured in serum by ELISA

Results: Mean Serum IL-18 [pg/ml], were 383.12 +/- 87.93 , 710.5 +/- 212.92, 836.5 +/- 116.83 and 197 +/- 14.37 pg/ml in the four groups respectively The results revealed that serum IL-18 increased significantly in patients with hepatocellular carcinoma more than chronic HC V patients [ with and without cirrhosis]. Moreover, patients with cirrhosis had significantly higher levels of serum IL-18 than in non-cirrhotics and controls. A positive correlation was found between serum IL-18 and Child Pugh scoring in groups II and 111 patients [r = 0.86, 0.94 respectively] [p = 0.00 in both groups], as well as with histopathological [necroinflammatory] grading in groups I and II [r=0.82, 0.98 respectively ][ p=0. 00]

Conclusions: From the previous results we can conclude that IL-18 is involved in the activity of the disease process and might have a prognostic value in the progression of liver cirrhosis and HCC