Correlation between Serum Neopterin and the Activity of Hepatitis C Virus Infection

Abstract

Chronic hepatitis c virus infection represents a major cause of liver disease in Egypt with national prevalence rate of 14.7% of population. Chronic hepatitis C infection with its complication (cirrhosis and hepatocellular carcinoma) have slowly progressive course with accompanied liver inflammation and fibrosis. Multiple studies were done to detect new markers for follow up disease progression and its prognosis. One of these markers is neopterin which is produced by monocytes /macrophages when activated by interferon-gamma secreted from T lymphocytes as a part of body immune response against hepatitis C virus infection. The current study aimed to asses correlation between serum neopterin levels as a systemic inflammatory marker and hepatitis c virus infection and to assess the relation between serum neopterin level and demographic features, abdominal ultrasonography findings, liver biopsy findings. Fifty persons were included in the current study, 25 patients having chronic hepatitis c virus infection without apparent cirrhosis and 25 healthy patients were considered as the control group. The current study revealed that: Serum neopterin level was significantly elevated in patients with chronic hepatitis C virus compared to healthy control individuals. Neopterin level was significantly correlated to the gender of patients, being higher in male than female. Neopterin level was not significantly correlated to serum AST and ALT. Neopterin level was highly significant positive correlated to PCR for HCV RNA (quantitative). Neopterin level was significantly correlated with the grade of the disease activity in the liver biopsy being higher in advanced liver necro inflammatory activity, but not significantly correlated with the grade of fibrosis. Moreover there was obvious relation ship between plasma level of neopterin and CHC virus, this could be approved through the ROC curve with cutoff value > 9 nmol, sensitivity of 88%, specificity of 100% and accuracy of 95.5%.