الفهرس 
Introduction
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Egypt has the highest rate of hepatitis C virus infection (HCV) throughout the world and it is the ledading cause of hepatocellular carcinoma (HCC) and cirrhosis.Type 2 diabetes (T2D) tends to increase HCC development and induces poor prognosis for those patients.Interleukin-1αand Interleukin-12 plays an important role in the inflammatory process. Interleukin-1α and Interleukin-12 therefore may be useful non invasive immunological inflammatory markers for prediction of liver changes among patients with chronic hepatitis C ( CHC) and follow up of (CHC) patients with diabetes to prevent conversion fromCHC to cirrhosis .
The present study was designed to determine the level of IL-1 α and IL-12 of HCV related chronic liver disease and to investigate the possible role of those cytokines in HCV related chronic liver disease by comparing serum levels of those cytokines among different groups of CHC with or without diabetes mellitus.
The study was carried out at Medical Microbiology &Immunology Department. Patients were attending Tropical Medicine and Gastroenterology Department and Hepatitis Virus Outpatient clinic, Assiut University Hospitals, the study included 76 HCV infected patients,they were 69 males (90.8%) and 7 females (9.2%) Their ages ranged from 30 to 70 years.About 60.5% of them were coming from rural areas.Both groups were subjected to detailed history taking andclinical examination.Liver disease stage was evaluated by liver function tests andabdominal ultrasonography.Diagnosis of HCV was based on detection of anti-HCV antibodies by ELISA, raised liver enzyme and HCV RNA load by real time PCR.The levels of IL-1α and IL-12 were detectedby Sandwich ELISA Technique
Patients were divided into four equal groups; group I (chronic hepatitis C not diabetic) (CHC), group II (HCV related cirrhosis not diabetic)(LC),group III (chronic hepatitis C,diabetic) (CHD).group IV (HCV related cirrhosis –diabetic) (LCD).Also 10 age and sex matched healthy subjects were enrolled as a control group.
It was found that the most frequent risk factor for hepatitis C was history of operation, followed by tooth extraction,blood transfusion and then antibilharzial injection.Viral load was found significantly higher among non cirrhotic (groups I,III) than cirrhotic (groups II,IV) patients.
Levels of ALT and AST, total bilirubin level (TBL) and prothrombin time (PT) werehigher in groups II,III and IV.Moreover,Hemoglobin level and platelet count (PLT)were lowerin groups II and IV.
The levels of serum IL-1α and IL-12 were significantly higher in the 4 groups in comparison with the controlgroup.High statistically significant differences were also observed between the 4 groups (P value <0.001).Generally the highest levels of both cytokines were observed in group IV.The levels of the 2 cytokines were higher in both groups II,IV (cirrhotic) than groups I,III (non cirrhotic).Morever their levels were higher in group IV (diabetic cirrhotic) than II (non diabetic cirrhotic) and group III (diabetic non cirrhotic) than group I (non diabetic non cirrhotic).Stronger correlations were observed between the serum level of IL-1α and that of IL-12 in cirrhotic groups (II,IV).
Significant correlations were observed between the serum levels of both IL1α, IL-12 and the levels of ALT& AST, stronger in the non-cirrhotic groups. IL-1α showed stronger correlations with ALT than AST . PT in cirrhotic patients was strong positively correlated with IL1α but not with IL12 .Also, significant correlations were detectable between the serum levels of both cytokines and the HC viral load but was stronger in non cirrhotic patients. Blood levels of fasting blood glucose showed significant correlations with the levels of both cytokines in cirrhotic patients alone, stronger with IL12 than IL1α.
Significant correlations were observed between the serum levels of both cytokines and ALT & AST, stronger in diabetic than non-diabetic patients especially for IL1-α. PT showed weak positive correlations with the 2 cytokines in the diabetic groups and weaker correlation with IL-1α alone in the non diabetic patients.Also,weak correlation was detected in the diabetic patients between the serum levels of both cytokines and the TBL. Significant negative correlations were found between PLT and the 2 cytokines in the diabetic groups and a weaker negative correlation with IL-1α alone in the non-diabetic patients.In addition, significant correlations were detectable between the serum levels of both cytokines and the HC viral load in both diabetic and non diabetic groups.Blood levels of fasting blood glucose showed significant correlations with the levels of both cytokines in diabetic patients alone.