Serum levels of IL-10, TNF-alpha and neopterin in chronic hepatitis c virus infection and their relation to viral load

ABSTRACT

Hepatitis C virus [HCV] has been shown to be an etioligic agent responsible for chronic liver disease with eventual progress to cirrhosis in 20% of patients. While the immunologic mechanisms in chronic HCV infection have not been clearly defined, it is believed that cytokines are involved. In this study, the serum levels of IL-10 [by ELISA], TNF-alpha [by ELISA] and neopterin [by RIA] in patients with chronic hepatitis C [n = 40] were measured. They were compared with biochemical [ALT, AST, GGT] and viral [serum levels of HCV-RNA] indicators of infection. In addition, serum autoantibodies [anti-LKM, ANA, ASMA and APCA] were done by the indirect immunofluorescence technique. Also, twenty healthy subjects were enrolled as a control group. Serum levels of IL-10, TNF-alpha and neopterin were significantly increased in HCV infected patients versus normal control group [P<0.001]. There was significant positive correlation between serum level of IL-10 and serum level of HCV-RNA [P < 0.001]. There was also a significant negative correlation between serum level of TNF-alpha and both of serum level of HCV-RNA [P < 0.05] and IL-10 [P < 0.001]. ANA was detected in 7.5%, ASMA in 37.5% and APCA in 2.5% in these patients. In summary HCV patients have an altered immune reactivity that may play a role in the pathogenesis of chronic HCV. An activated T cell response is present in these patients as manifested by increased circulating cytokine levels and presence of serum autoantibodies. Proper understanding of the immune response in HCV patients should make it possible to design future treatment strategies for HCV infection