A STUDY OF SERUM TUMOR NECROSIS FACTOR-ALPHA IN PATIENTS WITH CHRONIC VIRAL HEPATITIS
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Recent advances in molecular medicine have focused attention on cytolcines in the machinery of inflammation and immune response. Tumor necrosis factor (TNF-a) is a cytolcine produced primarily by activated monocytes and lymphocytes, that posses pleiotropic properties. TNF-a has been involved in the pathogenesis of diversity of liver diseases including viral hepatitis. The aim of this study was to investigate a group of patients with histologically - documented chronic viral hepatitis for the level of serum TNF-a with particular attention to its correlation with disease activity. Thirty patients with biopsy-proven chronic Viral hepatitis and ten healthy controls were studied in this work. Cases included 25 males and 5 females with an age range of 23 to 67 years. Controls included 8 males and 2 females with an age range of 25 to 60 years. Cases were classified into three groups : Group I consisted of 6 cases with chronic hepaitis B. Group II 14 cases with chronic hepatitis C and Group 111 10 cases with evidence of combined B and C viral infections. Results revealed that serum TNF-a levels were signcantly increased among patients with chronic viral hepatitis compared to controls. TNF-a significantly correlated with the severity of the .activity of viral infection as gauged by the histological activity index (HAD. There was, however, no statistically significant difference between the three groups of cases and each other. It was concluded that TNF-a is a better measure of disease activity than conventional bio-chemical liver function tests. Moreover, monitoring of TNF-a along with ALT during treatment might provide more precise information of effectiveness of therapy.