ABSTRACT
Background and Study Aims: Thrombocytopenia (TP) in chronic hepatitis C virus (HCV) is a common finding either directly due to viral infection of platelets or indirectly due to immune alteration triggered by the virus, the consequences of HCV- induced cirrhosis and portal hypertension, or induced by Interferon (IFN), the corner element of the standard of care (SOC) therapy for HCV. This study aimed to evaluate TP in patients with chronic HCV, and to evaluate the mutual effect between SOC and TP. Methods: The study was conducted on 209 patients with chronic HCV from Railway Hospital, Cairo. Patients were divided into two groups, Group (I): 144 patients who received SOC therapy, and Group (II): 65 patients who did not receive therapy. All patients were subjected to clinical examination, laboratory investigations, abdominal ultrasonography, and liver biopsy. Results: TP was a common finding (60/209; 28.7%), more in group I (33/ 60; 55%, mean= 124.8±16.2/ml), and was significantly worse in group II (mean= 99.7±36.3/ml, p=0.008). Along the course of treatment, 2 significant drops of platelet count took place, nadirs at W8 and W24. TP was significantly related to hepatitis activity and hepatic synthetic function, and not related to the viral load. Four cases developed severe TP, only 1 of them continued therapy on IFN dose reduction. Conclusions: TP is a common complication among HCV patients and along its SOC therapy, particularly influenced significantly by splenomegaly and advanced fibrosis.
ABSTRACT
Background: Interleukin-10 (IL-10) and IL–12B single nucleotide polymorphisms (SNPs) are confirmed to influence the natural history of hepatitis C virus (HCV) infection, and the response to treatment. This work aimed at evaluating the impact of SNPs in IL-10 gene at positions _1082, _819, and_592 and IL-12B gene on the response to the standard of care (SOC) treatment in Egyptian patients with chronic HCV. Methods: Eighty seven patients with chronic HCV treated by SOC therapy and 20 healthy controls were tested for SNPs in IL-10 at _1082 G/A, _819 C/T and_592 C/A and in IL- 12B (30-UTR 1188-A/C) by polymerase chain reaction (PCR). Patients were divided according to their virologic response into 2 groups; group Ι=patients who achieved sustained virologic response (SVR) and group Π = non responder (NR) patients. Results: SNPs of IL-10 at _1082 G/A and_819 C/T showed that; GA and TT genotypes were significantly related to SVR (P=0.001 and 0.007 respectively). IL-12 genepolymorphisms showed that; CC genotype was significantly related to SVR group (P=0.01) while AA genotype was significantly related to NR (P=0.01). Conclusions: Studying SNPs of IL-10_1082 G/A, IL-10_819 C/T and IL-12B (30-UTR 1188-C/A) proved GA, TT and CC genotypes, respectively, to be good predictors for SVR. Conversely, SNPs of IL-12 C/A proved AA genotype to be good predictor for NR.