Prognostic value of serum soluble interleukin-2 receptor in egyptian chronic hepatitis c patients treated with pegylated interferon and ribavirin

Abstract EN

Background / Aim : hepatitis C virus (HCV) is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma worldwide.

A strong Th1 response seems to be associated with viral clearance.

It is generally accepted that T cell activation is characterized by the synthesis and secretion of interleukin-2 and by the expression of Interleukin-2 receptors (IL-2R) on the cell surface of immune cells.

The aim of this study is to determine the evolution of soluble IL-2 receptors (sIL2-R), as an indicator of activation of T cells in HCV patients treated with ribavirin and paginated interferon and its correlation with outcome of therapy Methods : 53 naïve (previously not treated) chronic HCV patients eligible for criteria of therapy according to the international guidelines were recruited.

Paginated interferon alpha-2a (IFN 2- a) was used subcutaneously once a week for 48 weeks.

Ribavirin tablets in a dose of 13mg / kg were given daily in 2 divided doses Liver function and complete blood picture were monitored weekly for the first month and then monthly in the course of administration of therapy.

HCV-RNA was monitored every 3 month.

Sera were collected at different time point before and during therapy and tested for level of soluble IL2-R using ELISA techniques.

Results : prior to therapy, mean serum soluble IL-2R level was significantly higher in patients with HCV as compared to controls (3709.05 ± 291.4 pg / ml versus 1770.6 pg / ml ± 220.3, p < 0.01).

After end of therapy, patients were retrospectively classified into 2 groups, responders and non-responders.

In responders, the level of sIL-2R raised significantly after 4 weeks of therapy as compared to pre-treatment level (4501 ± 309 pg / ml versus 3550 ± 291 pg / ml p = 0.01).

In Non-responders, however, the difference in serum sIL2R before therapy and after 4 weeks of therapy was non-significant (4021 ± 567 pg / ml versus 3934 ± 550 pg / ml p = 0.9).

The levels of serum sIL2-R significantly correlated in a linear model with ALT levels before starting the therapy.

Conclusion : monitoring of sIL-2R levels may therefore be of value as an adjunct to the measurement of serum ALT and HCVRNA in predicting the response to interferon therapy in HCV patients.