الفهرس 
TitleOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus divided into seven genotypes and 67 subtypes. Due to this variation, hepatitis C virus associated with differential prognosis and influence antiviral therapy selection.
HCV infection is considered as one of the leading causes of chronic liver disease, mainly, hepatocellular carcinoma.
Macrophages are essential components of the human host immune system, which upon activation facilitates abroad pallet of immunomodulatory events including release of pro- or anti-inflammatory cytokines and chemokines, restoration of immune homeostasis and or wound healing.
Monocytes develop in the bone marrow and represent the primary type of Mononuclear phagocyte found in the blood. They were long thought of a source for tissue macrophages.
The scavenger receptor CD163 expressed by macrophages may be of promising clinical relevance in estimating the severity of inflammation and infiltrates in most solid tumors where intra-tumor as well as CD68+ peri-tumoral macrophages are associated with poor prognosis in patients with HCV. In humans, the migration of classical CD14-CD16+ and intermediate CD14+CD16+ monocyte populations are induced at high levels during liver inflammation. In this study we investigate the relationship of soluble CD163 to disease outcome in patients with different stages of HCV infection. And the correlated CD163 with CD14+,CD16+, biochemical and hematological indicators for disease progression. In order to verify this purpose, peripheral blood mononuclear cells were isolated from 53 HCV patients at different stages of HCV infection and were used in both enumeration of CD14 and CD16 (by flow cytometry) and in assessment of mitogen-induced sCD163 (following a short term culture) using a standardized ELISA technique. Thorough clinical and radiological assessments were employed in patient classification as well as hepatic and extra-hepatic complication. So, the present study aimed at investigating the relationship of sCD163 either in sera or in culture supernatants of peripheral blood mononuclear cells to disease status and clinical outcome in patients at different stages of HCV infection.
Summary, C onclusion and Recommendation
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We conclude that
1. Hepatitis C infection is associated with a set of biochemical and hematological abnormalities that is correlative with disease advancement
2. Among end stage complications of HCV infections, AFP seems to characterize patients proceeding to HCC and cirrhosis, rather than chronically infected patients
3. Peripheral blood monocytes expressing the cognate marker CD14 is reduced in HCV patients with complications either due to transition towards affected liver or due to downregulation of expression or increase of shedding in peripheral circulation
4. CD16+ monocytes, on the other hand, is remarkably elevated due to HCV infection but does not seem to be affected significantly due to hepatic complications.
5. Double CD14,CD16 positive monocytes are significantly elevated due to chronic HCV infection and liver cirrhosis. However, tend to normalize in those having HCC as an end stage complications.
6. CD163 shedding into circulation, tends to be upregulated due to HCV infection and complications, most obviously in those having HCC
7. Similarly, both basal and mitogen-induced CD163 shedding is up regulated in all HCV clinical outcomes including chronic infection and hepatic complications (Cirrhosis and HCC)
8. It seems likely that HCV patients with express elevated levels of AFP, CD14+ monocytes as well as circulating sCD163 while CD16+ or CD14/CD16 double positive cells and PBMCs sCD163 don’t seem to be among major criteria discriminating those with HCC
We recommend that
1. Circulating CD14 and CD16 can be estimated to verify the exact course of modulations affecting respective monocytes during different stages of HCV infection.
2. Correlation of the studies parameters in particular sCD163 with other immunological variables such as cytokines, apoptotic markers, transcription factors and adhesion molecules may be mandatory for full characterization of HCV infection outcomes.
3. Circulating levels of sCD163 might be a valuable indicator of progression towards malignancy in HCV patients and, hence, is recommended to be among potential parameters useful as non-invasive prognostic index of hepatic HCV complications
4. Study of CD163 in liver co-infection such as HCV, HBV and schistosomiasis may be useful for obtaining more meaning for information about the extent of its involvement in liver complications.