الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hepatitis C is a major global health problem affecting all countries, It is estimated that approximately 180 million people world-wide or 2% of the world population are viremic.
However, as most acute hepatitis C virus (HCV) infections are asymptomatic, data on the incidence of new cases is difficult to obtain. Less than half of those infected have been diagnosed and less than 10% have accessed treatment of which only half have had a sustained virological response (SVR).
Approximately 75% of infected individuals are unaware of the infection and of these, approximately 70% to 85% will not clear the virus and remain chronically infected. Of those chronically infected a proportion will slowly progress to advanced liver disease and remain largely asymptomatic until liver cirrhosis and hepatocellular carcinoma develop.
The prevalence of such virus is reported to be higher in Egypt than in any other country. The prevalence of HCV among the general populations was variable according to the studies conducted, as it varied from 13 to 22% accordingly.
Interleukin-22 (IL-22) is an important cytokine that plays a pleiotropic protective, but sometimes also pathological, role in several tissues/organs, including the liver. IL-22 represents an important effector molecule of activated T helper 22 (Th22), Th1, and Th17 cells, as well as cytotoxic T-cell subsets.
The aim of the present work was to study the serum levels of interleukin-22 in chronic hepatitis C patients with or without cirrhosis and its correlation to the grading and staging of liver cirrhosis.
The study was conducted from November 2017 to April 2018. Patients were collected form tropical medicine department ward Alexandria main University Hospital as well as Damanhur fever Hospital, Behira governorate, Egypt.
This study was carried out on 100 subjects who were classified into three groups:
• group I: 40 patients with chronic HCV without liver cirrhosis
• group II: 40 patients with chronic HCV with liver cirrhosis who will be further subdivided according to child Pugh score into three subgroups according to Child Pough stratification.
• group III: 20 healthy controls.
All patients and control subjects were subjected to thorough historytaking and clinical examinations. Laboratory investigations including; routine hematological examination, liver function tests, renal function tests detection of HCV antibodies and PCR test for confirmation of HCV infection. Ultrasonographic examination of the abdomen was done for all patients. Serum levels of IL 22 were assayed in all patients and control subjects. Correlation between serum levels of IL22 and FIB4 as well as Child Pough scores were obtained.
from the present work the following results were obtained:
• There was significant difference between the three groups regarding IL-22. Its level was significantly higher in patient with HCV infection than control. Moreover, it was significantly higher in HCV patients with cirrhosis compared to HCV patients without cirrhosis as well as control subjects, (F=367.349, P=0.000)
• The correlation between serum levels of IL-22 and FIB4 scoring for grade of fibrosis showed strong positive correlation (r= 0.877, P=0.000) denoting increased levels of IL22 with progression of fibrosis.