الفهرس 
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Abstract
Hepatitis C is an infectious disease affecting the liver, caused by
HCV. The infection is often asymptomatic, but once established, chronic
infection can progress to scarring of the liver (fibrosis), and advanced
scarring (cirrhosis) which is generally apparent after many years. In some
cases, those with cirrhosis will go on to develop liver failure or other
complications of cirrhosis, including liver cancer.
Serum levels of IL-18 are elevated in chronic HCV infection and
directly associated with disease severity . High IL-18 has also been
observed in non-alcoholic fatty liver disease indicating a role and
importance as biomarker of liver disease beyond.
Because of the important role of IL-18 as a marker and mediator of
the innate immune response, its plasma levels and dynamics are candidate
biomarkers of HCV treatment effects and outcome.
The aim of this study was to evaluate the potential role of IL-18 in
the pathogenic process of CHC. We determined the concentrations of
serum IL-18 and its correlation to the HCV activity and the degree of
liver fibrosis, and evaluated the effect of triple regimen
sofosbuvir,ribavirin and interferon on IL-18 in hepatitis C patients.
This study was carried out on 27 CHC patients, 13 males and 14
females, admitted to Shebin El-kom Fever Hospital and all were treated
by the triple regmin anti hepatitis C drugs sofosbuvir, ribavirin and
interferon for 3 months .We meassured the levels of serum IL-18 in CHC
patients three times; the first was before beginning of treatment, the
second was after one week of treatment and the third was after three
months of treatment. Also we determined its correlation to the HCV
activity and the degree of liver fibrosis.IL-18 serum levels were
measurred by ELISA.
The study results revealed that:
1. chronic hepatitis C patients have significant elevation in serum levels
of IL-18 .
2. The serum levels of IL-18 were correlated positively with the
concentrations of ALT , AST , creatinine and serum billirubin in CHC
patient.
3. Serum levels of IL-18 showed a significant association with Child-
Pugh and MELD scores .
4. Serum IL-18 levels differed significantly among patients with different
stages of fibrosis with higher levels in the advanced fibrosis stages .
5. Serum IL-18 levels reduced after one week of treatment and
significantly reduced after 3 months of treatment.
6. Serum IL-18 levels were correlated positively with the viral load of
HCV.
7. Three patients relapsed after 6 months of treatment and they became
HCV-RNA PCR positive.