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Abstract
Chronic hepatitis C is a serious worldwide problem which may lead to cirrhosis and hepatocellular carcinoma. The prevalence of HCV in Egypt is very high (about 20% of the population). The only available treatment for HCV is the alpha interferon in combination with the guanosine analogue ribavirin. The aim of this study was to evaluate the immune response of patients treated with either standard or pegylated interferon alpha-2b in combination with ribavirin during the course of therapy (at the start of treatment, after 4, 8, 16, 24, 48 and 72 weeks (24 weeks after the end of treatment). In addition, we evaluated the effect of antiviral therapy on the HCV specific T-cell responses and correlated these changes with the clinical outcome. Furthermore, we investigated the immunogenicity of a number of HCV core peptides on the PBMCs of the treated patients. We enrolled 42 patients with chronic HCV in this study, 28 males and 14 females during the period from July 2001 to December 2003. All patients underwent 48 weeks of combined IFN-a/ribavirin therapy and followed up 24 weeks after the end of therapy. Seventeen patients treated with standard IFN and 25 patients treated with PEG interferon. IFN-a-2b (3 million units) was administered three times a week by subcutaneous injection, while PEG interferon was injected once a week in a dose of 100 µg. Ribavirin (600-1000 mg) was administered orally daily in divided doses (3-5 capsules/day) according to body weight (>11 mg/kg). The response to therapy was assessed mainly according to the presence or absence of HCV RNA in the serum 24 weeks after the start of treatment. As well as changes in ALT and AST levels were analyzed. For patients received PEG interferon, 56% respond to treatment, 28% were reported to be virologic non responders and 16% were relapsers. For patients received STD interferon, 58.8% respond to treatment, 17.7% did not respond to treatment and 23.5% relapsed after the end of treatment. To evaluate the immune response of the treated patients, we analyzed the quantity of IFN-y secreted by the immune cells as a marker for the immune response using the ELISPOT assay. I In conclusion, our study demonstrated that there was no difference in the immune response of patients treated with either PEG or STD | interferon therapy. Moreover, we identified a number of HCV core peptides which have high immunogenicity. These peptides will be used in further experiments to study their protective immunity and capacity in experimental animals.