Immunomodulatory therapy in chronic hepatitis C infection

The imbalance of Th1 and Th2 cytokine production may play an important role in immunopathogenesis of persistent HCV infection and disease progression. BCG vaccine induces TNF gamma, causing Th1 type immune response. This study aimed to demonstrate the immunomodulatory effect of BCG vaccine on the progression of Hepatitis C viral infection. Forty patients with chronic hepatitis C were included [Group I] as well as 10 healthy controls [Group II]. All participants were subjected to: clinical examination, laboratory investigations, HCV antibodies by ELISA, quantitative PCR for HCV, HBsAg, HBcAb, serum IL-4, serum IL-2, tuberculin test and BCG vaccine [patients only]. Tuberculin positive, diabetic and bilharzial patients were excluded. The previous work-up was repeated only to group I at 12 weeks after BCG vaccine. Showed significant statistical elevation of both IL-2 and IL-4 pre vaccination compared to controls. Significant statistical elevation in levels of IL-2 and lowering in levels of IL-4 at 12 weeks post vaccination occured in patients. Levels of IL-4 were still significantly higher than those of controls. A significant lowering of viremia as detected by quantitative PCR also occurred BCG vaccine could be considered a new line of immune therapy based on its immunomodulatory action on chronic hepatitis C patients