1Hanaa M. Alam El-Din, 1Mohammed A. Attia, 2Mohammed R. Hamza, 2Hussien M. Khaled, 2Thoraya, M. Abdel-Hamid and 3Sohair A. Eisa
Departments of 1Virology and Immunology unit, Cancer Biology, 2Medical Oncology and 3Clinical pathology, National Cancer Institute, Cairo University, Cairo, Egypt.
Viral hepatitis is a common and important problem in immunocompromised cancer patients. The present study was conducted to investigate changes in some cellular and humoral immunological parameters as a consequence of HCV infection in non Hodgkin’s lymphoma patients (NHL). The study included 40 NHL patients: 20 anti-HCV antibody positive (Gr.I ), and 20 anti-HCV antibody negative (Gr.II ). In addition, forty non-cancer controls (NCCs) were included: 20 of them were anti-HCV antibody positive (Gr.III) and 20 anti-HCV antibody negative (Gr.IV). The studied immunological parameters included serum levels of interleukin-1 (IL-1), interleukin-2 (IL-2), interleukin-6 (IL-6), and soluble tumor necrosis factor receptors (s-TNFr) measured by ELISA, as well as assessment of T and B lymphocyte subsets by PAP immunostaining method. Mean IL-1 level (pg/ml) was significantly higher in Gr.I (14 ± 6) and Gr.III (20 ± 12) as compared to those in Gr.II (7 ± 5) and Gr.IV (9 ± 6). Mean IL-2 level (pg/ml) was also significantly higher in Gr.I (132 ± 101) and Gr.III (135 ± 59) compared to those in Gr.II (36 ± 29) and Gr.IV (31 ± 48). On the other hand, level of IL-6 showed no significant difference between groups. The mean level of sTNF-r, (ng/ml) was only significantly higher in Gr.I (2.9 ± 1.7) when compared to that in Gr.IV (1.9 ± 2.2). In group IV, the average percentage of CD3 (70 ± 4 %) and CD4 (44 ± 5 %) were significantly higher than in those of Gr.I (CD3= 51 ± 11%, CD4 = 30 ± 12%), Gr.II (CD3 = 52 ± 7%, CD4 = 30 ± 8%), and Gr.III (CD3 = 52 ± 9%, CD4 = 26 ± 8%). From all the above immunological and virological features two main tips could be inferred: (1) HCV leads a mild course of infection in NCCs evidenced by normal ALT level in all but 20% of subjects, normal IL-6, sTNF-r, lower counts of CD4+ T cells and hence a mild hepatocellular injury, and (2) In the immunocompromised NHL patients the virus leads potentially more aggressive course as evidenced by higher viremia, as well as significant elevation in sTNF-r, and CD8+ depression.