الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 288 |  |  |
| | | from | 288 | | |
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