الفهرس | Only 14 pages are availabe for public view |
Abstract Hepatitis C virus infection is the leading cause of advanced liver disease and a major international public health problem. There are about 170 million chronic HCV carriers throughout the world. HCV infection appears to trigger the development of autoantibodies. The production of these autoantibodies in viral infection is regarded as viral-induced autoimmunity. There are two suggested mechanisms for the production of these antibodies; the first mechanism is molecular mimicry between HCV polyprotein and three human nuclear antigens, while the second mechanism is Polyclonal B cell activation by persistent HCV infection. The aim of this study was to determine the prevalence of several autoantibodies in chronic hepatitis C patients, and to find out whether the pattern of these autoantibodies was associated with hepatitis C virus (HCV) treatment. The study included one hundred and twenty Egyptian patients, divided into three groups: the first group included forty chronic HCV patients treated with pegylated interferon (30 males and 10 females), the second group included forty chronic HCV patients treated with liver support therapy (32 males and 8 females) and the third group included forty chronic liver diseases patients other than HCV (26 males and 14 females). To investigate this aim, the following investigations were carried out for all patients: serum ALT, serum AST, quantification of HCV viremia using quantitative PCR, detection of the presence of ANA, ASMA, AMA, APCA and LKMA antibodies using indirect immunofluorescence and detection of cryoglobulins. Summary ------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------- 61 The results revealed that: Concerning Liver function tests, AST and ALT levels in PEG-IFN group were found to be lower than other groups (liver-Support group and non-viral control group). In addition, the results showed that AST and ALT levels in non-viral control group were higher than liver-Support group. There was highly significant difference between median values of AST and ALT in the three groups. There was no significant correlation between ALT level, viral load and PEG-IFN dose (duration of therapy) among PEG-IFN group, while a negative significant correlation was found between AST levels and viral load. Also negative significant correlation was found between AST level and PEG-IFN dose. There was positive significant correlation between AST and ALT levels among liver support group, while there was no significant correlation between AST, ALT levels and viral load in liver support group. As regard the autoantibodies, the study revealed a highly significant statistical difference between PEG-IFN group and non-viral control group as regards ANA (30% and 0% respectively) and ASMA (42.5% and 10% respectively), and there was significant statistical difference between PEG-IFN group and non-viral control group as regards to LKMA (10% and 0% respectively). Also, there was highly significant statistical difference between liver support group and non-viral control group as regards ANA (20% and 0% respectively) and there was significant statistical difference between liver support Summary ------------------------------------------------------------------------------------ --------------------------------------------------------------------------------------------------- 62 group and non-viral control group as regards LKMA (10% and 0% respectively), while there was no significant difference between liver support group and non-viral control group as regards ASMA (25% and 10% respectively). Concerning cryoglobulins, this study showed that there was no significant difference in PEG-IFN group and liver support groups as regards cryoglobulins prevelance (45% and 47.5% respectively) in comparison to 45% positivity in non-viral control group. On the other hand, APCA and AMA were not detected in the three studied groups. ASMA was present in the patient group receiving PEG-IFN therapy 6.7 times more than non-viral control group, so ASMA was found to be the most autoantibodies present in HCV patients treated with PEG-IFN |