%0 Journal Article
%T Serum Inter-Alpha-Trypsin Inhibitor Heavy Chain 4 (ITIH4) in Children with Chronic Hepatitis C: Relation to Liver Fibrosis and Viremia
%A Mostafa M. Sira
%A Behairy E. Behairy
%A Azza M. Abd-Elaziz
%A Sameh A. Abd Elnaby
%A Ehab E. Eltahan
%J Hepatitis Research and Treatment
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/307942
%X Liver fibrosis and viremia are determinant factors for the treatment policy and its outcome in chronic hepatitis C virus (HCV) infection. We aimed to investigate serum level of inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) and its relation to liver fibrosis and viremia in children with chronic HCV. ITIH4 was measured by ELISA in 33 treatment-naive children with proved chronic HCV and compared according to different clinical, laboratory and histopathological parameters. Liver histopathological changes were assessed using Ishak score and compared with aspartate transaminase-to-platelet ratio (APRI) and FIB-4 indices as simple noninvasive markers of fibrosis. ITIH4 was measured in a group of 30 age- and sex-matched healthy controls. ITIH4 was significantly higher in patients than in controls ( £¿pg/mL versus £¿pg/mL; ). ITIH4, but not APRI or FIB-4, had a significant direct correlation with fibrosis stage ( , 0.961, and 0.389, resp.), whereas, the negative correlation of ITIH4 with HCV viremia was of marginal significance ( ). In conclusion, ITIH4 significantly correlated with higher stages of fibrosis indicating a possible relation to liver fibrogenesis. The trend of higher ITIH4 with lower viremia points out a potential antiviral properties and further studies in this regard are worthwhile. 1. Introduction Hepatitis C virus (HCV) infection is a serious health problem that may result in chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It is estimated that over 200 million people are infected worldwide, while 80% develop a chronic form [1]. HCV prevalence varies geographically, with rates of 1.7% in the United States, 2.1% in Southeast Asia, and 5.3% in Africa [2]. In children younger than 11 years, worldwide seroprevalence of HCV is 0.2% and in those older than 11 years it is 0.4% [3]. Egypt reports the highest prevalence worldwide ranging from 8.7% in upper Egypt to 24.3% in lower Egypt with genotype 4 in more than 90% of those infected [4]. Studies of the magnitude of HCV infection in Egyptian children revealed a prevalence of 3% in upper Egypt and 9% in lower Egypt [5]. Liver disease seems to be milder in children than in adults; however, the natural history of HCV infection acquired in infancy and childhood remains poorly characterized and the long-term outcome of the disease is still a matter of debate [2]. Although liver biopsy represents the gold standard for evaluating presence, type, and stage of liver fibrosis and for characterizing necroinflammation, it remains an invasive procedure with inherent risks. Thus, it cannot be
%U http://www.hindawi.com/journals/heprt/2014/307942/