Estimation of cellular immune response by evaluation of some cytokines in immunopathogenesis of chronic hepatitis B and C pre- and post- treated Iraqi patients (in vivo and in vitro)

Two groups of chronic hepatitis B and C virus patients were divided into Pre-treated patients (25 CHB patients with positive HBs Ag for more than 6 months and 40 CHC patients), and post-treated patients [12 CHB patients (4, 6, and 2 were treated with lamivudine, IFN-α and combination of LMV + IFN-α respectively), and 27 patients for CHC (3, 13 and 11 patients were treated with Ribavirin, IFN-α and combination therapy (RBV+ IFN-α) respectively].These patients were followed up for 6 months. By using ELISA technique, levels of IL-6, IL-10, IFN-γ and TNF-α were measured in vivo and in vitro (supernatant of PBMCs stimulated with PHA) and compared with healthy control. The mean level of IL-6, IL-10 and TNF-α in CHB patients showed significant differences (P 0.05) between pre- and post-treated patients in vivo and in vitro, while there was no significant difference in IFN- γ between pre- and post-treated patients in vivo and in vitro. The difference between control and CHB patients was highly significant (P 0.0001) in IL-6 , IL-10 and TNF- α levels in vivo and in vitro. In CHC patients the mean levels of IL-6, IL-10, IFN- γ and TNF- α showed significant difference between pre- and post-treated patients in vivo and in vitro. There was highly significant difference (P 0.0001) between patients and control in IL-10 levels. Hence, these observations indicate the predominance of Th2 cytokine, which promote the persistency of the CHB and CHC virus.