Evaluation of Interleukin-8 and HCV RNA in Chronic Hepatitis C Patients as Predictors of Response to Pegylated Interferon/Ribavirin Therapy at 12 and 24 Weeks, ADEL A. HASSAN, NADER A. NEMR, KHALIL A. KHALIL, AMANY M. HASSEN, WAHEED F. HESSAM and TAMER M. ATTIA
Abstract
Background: Numerous studies suggest that HCV-induced changes in levels of chemokine and cytokine expression may be involved in HCV antiviral resistance, persistence, and pathogenesis. Also found that the HCV NS5A protein induces expression of the proinflammatory chemokine IL-8 to partially inhibit the antiviral actions of IFN in vitro.
Aim: To investigate the impact of serum levels of inter-leukin-8 in patients with chronic hepatitis C viral infection and baseline HCV RNA levels as predictors for response to Interferon/Ribavirin therapy in patients with chronic HCV infection in the centre for treatment of HCV in Ismailia Fever Hospital-East Egypt.
Methods: This descriptive study was conducted on 42 patients to determine the correlation between levels of inter-leukin-8 in the serum of patients with chronic hepatitis C infection and baseline HCV RNA and response to pegylated Interferon/Ribavirin after 12 and 24 weeks of therapy. All investigations and follow-up had been carried out in the centre according to the national program for treatment of chronic hepatitis C virus.
Results: Among the total studied 42 patients the mean age was 41.5 years old. About half of the studied patients were males (52.4%) and more than half of the patients were from rural areas (61.9%).
A 73.8% of the studied patients were responders to inter-feron therapy while 26.2% were non responders. Seven (16.7%) of these non responders have shown positive PCR and discon-tinue treatment at 12 weeks while the remaining 4 patients (9.5%) were recorded as non responders at 24 weeks of therapy. There was no statistically significant difference between responders and non responders regarding age, sex and residence. Responders have significantly lower hemoglobin values, FBS, a-fetoprotein and baseline PCR than non re-sponders. More than half of the whole studied patients have IL-8 value 2-6 (mid range elevation) (64.3%) while 35.7% shows high level of IL-8 (>!14). Responders have lower mean of IL-8 with statistically significant difference than non responders (7.9 versus 13.3). Most of responders (74.2%) have IL-8 value ranging from 2-6 while most of non responders (63.6%) have high level of IL-8 (>!14). Patients with IL-8 (2- 6) are less likely to be non responder with RR=0.3 (95% CI: 0.1- 0.9) while patients with IL-8>!14 are at higher risk of being non responder with RR=3.1 (95% CI: 1.09-9.03). This shows the predictive characteristics of low levels of IL-8 pretreatment and low baseline HCV RNA in prediction of response to interferon/ribavirin therapy at 12 and 24 weeks respectively.
Conclusion: Most of responders have low levels of pre-treatment IL-8, while most of non responders have high levels of IL-8, and also Low pretreatment levels of HCV RNA were predictive to response.