Activated Cellular Immunity in Chronic Hepatitis C.

The importance of local immune mechanisms in the development of chronic hepatitis C and its relation with systemic immune disorders is becoming clear and suggests a more generalized involvement of the immune response in this disease. For this reason, we have investigated the serum concentrations of the soluble immune activation markers neopterin, β2-microglobulin and interferon-γ in 28 patients with hepatitis C virus related chronic active hepatitis (n=20) or chronic persistent hepatitis (n=8). Increased levels of neopterin, β2-microglobulin and interferon-γ were found in a subgroup of the patients. Serum β2-microglobulin and neopterin concentrations were strongly related. Patients with chronic active hepatitis had higher β2-microglobulin levels than those with chronic persistent hepatitis. There were no significant differences in neopterin and interferon-γ levels between chronic active hepatitis and chronic persistent hepatitis. A strong association was found between older age and higher β2-microglobulin levels. Because patients with chronic active hepatitis were older than patients with chronic persistent hepatitis, older age may have at least partly contributed to the difference in β2-microglobulin. Because of the known association between cell-mediated immune activation and the production of interferon-γ, neopterin and β32-microglobulin, our results imply that a Th1-type immune response is stimulated in chronic hepatitis C.