Prognostic value of serum soluble interleukin-2 receptor in Egyptian chronic hepatitis c patients treated with pegylated interferon and ribavirin

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