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
