Estimating the levels of interleukin-2 and interleukin-4 in the blood of people with hepatitis in Iraq-Ramadi city

Hepatitis B and hepatitis C virus infections are major health problems worldwide due to their significant morbidity and mortality rates. Chronic infections of both hepatitis B virus and hepatitis C virus can lead to serious consequences such as severe symptoms, reduced quality of life, disability and death. The mechanisms by which liver damage occurs during persistent infections are not fully understood. Although HBV and HCV are both viruses that primarily affect the liver, they exhibit different mechanisms of interaction with the host immune system. The immune system's response to hepatitis viruses involves several components, including immunoregulatory cytokines produced by T-lymphocytes. Cytokines are a class of protein molecules that play a role in various biological processes and are synthesised by a wide range of cells, particularly T helper 1 and 2 cells. T helper 1 cells secrete pro-inflammatory cytokines, while T helper 2 cells secrete anti inflammatory cytokines. T helper 1 cytokines are an integral part of the cell-mediated immune process and are required for defence against intracellular infections. They are also closely linked to the healing process. T helper 2 cytokines play a crucial role in the control of humoral immune responses and their increased levels are often linked to the progression of chronic infections. The liver plays a crucial role in the synthesis of cytokines, which are essential for both normal and abnormal activities that take place in the liver. They have mechanisms to identify cells infected with viruses and control immune and inflammatory responses, as well as eliminate the virus and minimise tissue damage. Studies have shown changes in the activity of various cytokines during both hepatitis B and C infections. Dysregulation of pro-inflammatory and anti-inflammatory cytokine production plays a role in influencing the immunopathogenesis of both diseases. Changes in Th1 and Th2 cytokine levels in the blood and liver are important factors in both the persistence of viral infections and the immunological response of the host. Cytokines are involved in various processes in the liver that affect the development of chronic hepatitis. A total of 90 people participated in this study, and they were divided into three groups. The first group consisted of 30 patients diagnosed with chronic hepatitis B infection; the second group consisted of 30 patients diagnosed with chronic hepatitis C infection from patients hospitalised or treated at Ramadi Teaching Hospital; and the third group consisted of 30 apparently healthy controls. A 5 mL whole blood sample was collected from each participant using a gel tube (without anticoagulant) and centrifuged for 10 minutes at high-speed using a centrifuge device after 15 minutes at room temperature to ensure blood clotting. After obtaining the serum sample, the serum of each participant was distributed into 5 Eppendorf tubes and stored in the deep freezer. Enzyme linked immunosorbent assay method was used to measure IL-2 and IL-4 levels in the blood. An automatic biochemical analyser was used to measure AST, ALT and TSB levels in the blood. The minimum age was 33, 31 and 35 years, while the maximum age was 63, 61 and 64 years, respectively. Moreover, there was no statistically significant difference between the mean ages in all three groups (p-value 0.556). The number of males was higher than females among chronic hepatitis B and C patients. Mean serum IL-2 level was higher in chronic hepatitis B patients (8.62±0.46 pg/mL) than in chronic hepatitis C patients (3.53±0.38 pg/mL) and in the control group (1.62±0.19 pg/mL). In addition, there is a statistically significant higher difference between chronic hepatitis B and hepatitis C and control groups (p-value<0.001). Mean serum IL-4 level was higher in chronic hepatitis C patients (9.78±0.58 pg/mL) than in chronic hepatitis B patients (5.86±0.29 pg/mL) and control group (1.77±0.30 pg/mL). In addition, there is a statistically significant higher difference between chronic hepatitis C, hepatitis B and control groups (p-value<0.001). Biochemistry tests showed that the AST level in the blood of people with chronic hepatitis C (40.2±6.94 U/L) was higher than in people with chronic hepatitis B (34.6±8.40 U/L) or in the control group (24.1±6.64 U/L). There was also a statistically significant difference between the chronic hepatitis C and chronic hepatitis B infection groups (p-value 0.019) and a statistically significant higher difference between the chronic hepatitis C and B infection groups and the control group (p-value<0.001). ALT-GPT level in blood was also higher in people with chronic hepatitis C infection (65.7±8.17 U/L) than in people with chronic hepatitis B infection (42.5±11.9 U/L) or in the control group (6.60±1.20 U/L). In addition, there is a statistically significant difference between chronic hepatitis C and chronic hepatitis B infection and control groups (p-value<0.001). Furthermore, serum TSB concentrations were higher in patients with chronic hepatitis B infection (1.20±0.19 mg/dL) compared to patients with chronic hepatitis C infection (1.04±0.19 mg/dL) and control group (0.78±0.2 mg/dL). There was also a statistically significant difference between the chronic hepatitis B and chronic hepatitis C infection groups (p-value 0.005) and a statistically significant higher difference between the chronic hepatitis B and C infection groups and the control group (p-value <0.001). The study revealed that individuals with high biochemical indicators of liver disease and also infected with chronic hepatitis B and C had differences in IL-2 and IL-4 levels. These differences are indicative of the intensity of the inflammatory process occurring in the liver.