الفهرس 
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Abstract
The World Health Organization has declared hepatitis C a global health problem, with approximately 3% of the world’s population infected with HCV. Egypt has the highest prevalence of hepatitis C in the world. HCV is the main cause of liver cirrhosis and liver cancer in Egypt and, in deed, one of the top five leading causes of death In Egypt.
Anemia, neutropenia, leucopenia, and thrombocytopenia are among the numerous side effects of currently available HCV treatments. Preliminary data suggest that the infection itself can also induce autoimmune hemolytic anemia, leucopenia, and thrombocytopenia.
The functional activities of cytokines are needed to ensure adequate outpouring of mature neutrophil from the bone marrow to the peripheral blood. These factors include granulocyte colony stimulating factor G-CSF; and granulocyte macrophage colony stimulating factor GM-CSF. G-CSF is a glycoprotein which enhances the production of neutrophil in the bone marrow and modulates their activities. GM-CSF is an important mediator of inflammation. It also accelerates the production of macrophages, neutrophil and eosinophils.
The aim of the current study was to assess circulating G-CSF and GM-CSF and anti GM-CSF and G-CSF antibodies level in sera of patients with chronic HCV infection with neutropenia in order to assess the relationship between serum G-CSF and GM-CSF and their antibodies level with neutropenia.
The target population of the present study was (87) chronic HCV infected patients who were collected from Suez Canal University hospital, Ismailia and Health Insurance Hospital,Suez. the study group included (50) neutropenic chronic HCV infected patients,male represent 32(64%) while females represented18 (36.0%),and their ages were ranging from 30 – 75 years old with a mean value 51.25 ± 9.86.the control group included(37) chronic hepatitis C virus inrected patients without neutropenia
The mean value of serum (G-CSF) In neutropenic group ( 90.23 ± 62.06 μg/mL) was significantly higher than the same for non neutropenic group (5.49 ± 4.90 μg/mL) P value < 0.001
The mean value of serum (GM-CSF) In neutropenic group( 77.29 ±71.40μg/mL) was significantly higher than the same for non neutropenic group (0.80 ± 0.65μg/mL) P value < 0.001
Anti-G-CSF antibody was positive only in 5 patients of neutropenic group and negative (not detected) in non neutropenic group,while Anti-GM-CSF antibody was positive only in 3 patients of neutropenic group and negative (not detected) in non neutropenic
In the current study ,highly significant elevation of mean serum G-CSF and GM-CSF level was detected in neutropenic group. significantly higher than the same for non neutropenic group
Our results revealed that There is a statistically significant negative correlation this inverse relationship suggests that the neutrophils would regulate their own production through a negative feedback, between G-CSF , GM-CSF level and TLC, ANC in both groups
In the current study Anti-G-CSF antibody was positive only in 5 patients of neutropenic group and negative (not detected) in non neutropenic group which is Statistically significant .On the other hand Anti-GM-CSF antibody was positive only in 3 patients of neutropenic group and negative (not detected) in non neutropenic group which is Statistically not significant