The Role of Infla
The Role of Inflammatory Cytokines in Hepatitis C Hemodialysis and Non-uremic patients
Salwa R Ali 1, FatmaYounis2, Mansour I Sayed3,Fatma A Khalaf4 and Mahmoud A El Tahawy5
Departments of 1Internal Medicine, 2Tropical Medicine, 3Microbiology & Immunology,Faculty of Medicine-Al Azhar University
4Biochemistry &5Hepatology Departments, National Liver Institute-Menoufyia University
Abstract: There is a strong relationship between hepatitis C virus (HCV) and hemodialysis (HD). Therefore in end-stage renal disease (ESRD) patients, HCV remains a significant cause of morbidity and mortality.The aim of this study was to compare the biochemical characteristics of hepatitis C virus (HCV) in hemodialysis patients and in those with normal renal function. Sixty two HCV infected patients were selected for the study (Group I: included 28 with ESRD waiting for HD treatment and group II include 34 HCV infected patients with normal renal function, defined by creatinine<1 mg/dl) as well as 20 apparently healthy volunteers with matched age and sex with the patient group. They were subjected to full history and clinical examination, abdominal ultrasonogrphy. Laboratory investigations including: Liver and kidney function tests, complete blood count, hepatitis markers for HBV and HCV, HCV-RNA by quantitative PCR, C-reactive protein, IL-6 and hepatocyte growth factor (HGF). All investigations were done once for HCV patient (group II) and control group, the same investigations were done for ESRD (group I) three times (at start of the study, 6 and 12 months later after regular HD). The results of the study showed that, a significant increased in the levels of HGF, IL-6 and CRP among both group I and group II as compared to control group, while no significant difference was detected in their levels as comparing among group I and group II patients, while as regard viral load, no significant difference was detected between both patient groups. After 6 months of regular HD, the levels of ALT, AST, Alkaline phosphatase, total bilirubin, S. urea, S. creatinine, uric acid and S. potassium were significantly decreased as compared to before HD levels, and more decrease in their levels were detected after one year of regular HD. The S. albumin and creatinine clearance levels were significantly improved after HD. Moreover, HGF level was significantly increased in group I after 6 months of regular HD, and more significantly increased after one year of regular HD, while, the viral load was significantly decreased. In spite of decreasing levels of IL-6 and CRP, their levels were not reached statistical difference. The levels of HGF was significantly correlated to ALT, AST, total bilirubin, serum albumin, S. urea, S. creatinine, uric acid and viral load in group I patients. While IL-6 was only correlated to ALT and CRP was correlated to ALT and AST levels. In conclusion: The increasing serum levels of HGF in HCV infected patients regardless renal function and increasing its level after regular HD with improvement of liver and kidney suggesting its role as a protective against liver damage. Therefore, HGF agonist may be used to in these group of patients to ameliorate liver damage and disease progression.
[Salwa R Ali, FatmaYounis, Mansour I Sayed, Fatma A Khalaf and Mahmoud A El Tahawy. The Role of Inflammatory Cytokines in Hepatitis C Hemodialysis and Non-uremic patients]Journal of American Science 2012;8(10):706-712]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 95
Key words: HCV, hemodialysis, HGF, IL-6, CRP. Full Text 95