الفهرس 
Title: Core antigen levels and mthfr polymorphism as markers for liver steatosis in chronic HCV genotype 4 patients
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Abstract
Methylene tetrahydrofolate reductase (MTHFR) 677CT polymorphism was reported as a genetic variant in liver steatosis and fibrosis.This research was conducted to study the association between MTHFR 677CT polymorphism and HCV core with severity of steatosis in HCV GT4 patients. 111 HCV patients and 112 control subjects were recruited. Polymorphism was detected by RFLP analysis, core Ag was detected by ELISA. The study included 56 (51%) males and 55 (49%) females. The median age of the recruited patients was 39.4±8.6 years. The mean of (BMI) was 26.6±2.38 kg/m2. The degree of steatosis was correlated with age (p-value< 0.018), BMI (p-value< 0.003), platelets ( p-value< 0.001), albumin (p-value< 0.001), and Hb (p-value< 0.023) But there were no statistically significant differences between different grades of steatosis and serum ALT, AST, WBCs, Bilirubin, HCV RNA concentration and gender. Further statistical analysis showed a strong correlation between steatosis and the progression rate of fibrosis. The frequencies of MTHFR 677C{u2192}T genotypes (CC, CT, and TT) among chronic HCV patients who have steatosis were 32%, 50%, and 18%, respectively among controls where 65%, 28%, and 7% respectively, whereas among patients who have no steatosis were 63%, 33%, and 4% respectively. Comparing HCV patients with steatosis to controls revealed that the risk steatosis was 3.63 fold higher in patients who have steatosis the than in patients without the T substitution (95% CI 1.92-6.82) and 5.21 fold in patients with two alleles (95% CI 2.01-13.54) . When comparing the chronic HCV patients with steatosis to those without steatosis, the data showed that patients with single allele substitution i.e. CT had 2.88 fold more risk to develop steatosis than those having CC genotype (95% CI 1.08-7.68) . While those with 2 allele subsititution i.e. TT are 8.57 fold higher risk to develop steatosis (95% CI 1.03-71.08). The normal (C) allele frequency of MTHFR at position 677 in 87 chronic HCV patients who have steatosis was 57% while in controls it was 79%. The mutant (T) allele frequency in 87 chronic HCV patients who have steatosis was 43% while in controls it was 21% . We investigated the level of the circulating HCV core protein in the recruited patients. The data illustrate that there is no significant difference between the core antigen titer and degree of steatosis