RESUMO
Most acute and chronic liver diseases are characterized by inflammatory processes with enhanced expression of various pro-and anti-inflammatory cytokines in the liver. These cytokines are the driving force of many inflammatory liver disorders often resulting in fibrosis and cirrhosis. This work aimed to identify the role of serum IL-10 and IL-18 in the pathogenesis of chronic hepatitis C in different grades and stages of HCV patients and correlate their levels to the necroinflammatory grade and stage of fibrosis. A prospective study on [55] HCV infected patients 43 males and 12 females, their age ranged from 20 to 55 years with a mean of 41.3 year and [20] age and sex matched control [HCV-ve] from National Hepatology and Tropical Medicine Research Institute clinics, from whom consents were taken. The patients included in this study were those originally enrolled on protocol for treatment [interferon + ribavirin] where liver biopsy was required for eligibility of treatment according to the approved protocol. 5ml of blood was collected at the same day of biopsy for assessment of IL-10 and IL-18 levels in blood [ELISA technique]. Serum level of IL-18 was significantly higher in patients with chronic HCV [126.80 +/- 11.76 pg/ml] as compared to control group [45.97 +/- 5.26 pg/ml]; the level was even higher in cases with hepatocellular carcinoma [HCC]. IL-18 levels were significantly higher in patients with early fibrosis than in patients with advanced fibrosis., it was also higher in case with minimal to mild necro-inflammatory grade than in cases with moderate to severe grades, but that difference was not significant. As regards serum IL-10, the level was also higher in patients with chronic HCV [9.24 +/- 1.9 pg/ml] than control group [3.28 +/- 1.81 pg/ml]. Serum IL-10 level was significantly lower in early than advanced stages [P=0.04]. When classifying cases according to necro-inflammatory grade the IL-10 level was lower in minimal/mild cases than moderate /severe cases, but this difference wasn't statistically significant. Serum concentrations of IL-10 and IL18 could be correlated to the histopathological spoilage of the liver as they can predict the stage of fibrosis and hence can be used as indirect markers to assess the severity of liver disease in HCV infected patients. They can also be used as complementary markers in HCC patients