Study of the significance of percentage of peripheral CD4+ & CD8+ T cells and the hepatitis C virus genotypes in Egyptian patients with chronic hepatitis C.

Sequence comparison between isolates of hepatitis C virus (HCV) indicated that HCV can be classified into a series of distinct genotypes. The aim of this study was to determine the prevalence and clinical significance of HCV genotypes, to evaluate clinical relevance of percentage of CD4+ and CD8+ T cells in blood, and to find out predictors of response to interferon (IFN) therapy in Egyptian chronic hepatitis C (CHC) patients. The present study included 61 CHC patients who were subjected to HCV-RNA detection, HCV genotyping, and determination of percentage of CD4+ and CD8+ T cells in blood before and after six months treatment with IFN. Also, 20 healthy adults were enrolled as control group. Results revealed that genotype 4a is the prevalent HCV-genotype (85%) in Egypt. Only 21% of cases responded to IFN. The percentage of CD4+ T cells was significantly reduced, while the percentage of CD8+ T cells was significantly increased in patients with CHC. After IFN therapy only the percentage of CD8+ T cells was significantly reduced in non responders. Both genotype and percentage of both CD4+ and CD8+ T cells failed to predict response to IFN. It was concluded that genotype 4a is the predominant genotype in Egypt. CHC is a disease of liver which may be induced by a suboptimal immune response. Selection of CHC patients for treatment with IFN is still a controversial issue.