Cytokine network in nonresponding chronic hepatitis C patients with genotype 1: role of triple therapy with interferon alpha, ribavirin, and ursodeoxycholate

Objective: (i) to characterize the profile of tumor necrosis factor alpha (TNF α), interleukin-6 (IL-6), IL 10, Fas-ligand and transforming growth factor beta (TGF β), chronic hepatitis C (HCV) patients with genotype 1; (ii) to determine the influence of triple therapy (TT) with interferon α (IFN α) + ribavirin + ursodeoxycholic acid on these cytokines and (iii) to establish the relationship between the pro-inflammatory cytokines and the outcome of treatment. Design and Methods: 22 patients infected with HCV - genotype 1 a/b and non responsive to IFN-α monotherapy were enrolled in the TT. The controls were 49 HCV naïve patients with genotype 1 a/b. Cytokine levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: The baseline TNF α values (pg/mL) in the sustained responders (SRs) (63±3) were significantly lower than non-responders (NRs) (140±16) (p< 0.001). Baseline Fas (ng/mL) levels were also lower in SRs (4.3±0.2) than NRs (5.4±0.4) (p< 0.05). Conclusions: Fas and TNF α may be used as serological markers of inflammation and effectiveness of therapy.