Clinical Medicine and Diagnostics 2016, 6(6): 129-136 DOI: 10.5923/j.cmd.20160606.01 Evaluate the Sustainability of Viral Response to Antiviral Treatment by IL33 Assessment among Hepatitis C virus Saudi Patients Nuha Mahmoud Hamdi 1,2 , Haya Salem Al-Jurayb 3 , Haifa M. Al-Nafea 4 , Roaa Adnan Safar 5 , Khulood Mohamed Al Eisa 5 , Nagwa Mohamed A. Aref 2,6,* 1 Clinical Pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt 2 Immunology Departement, Reginal Lab, Ministry of Health, Riyadh, Saudi Arabia (SA) 3 Botany and Microbiology Department, College of Science, King Saud University, Saudi Arabia (SA) 4 Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Saudi Arabia (SA) 5 Reginal Lab. Ministry of Health, Riyadh, Saudi Arabia (SA) 6 Microbiology Departement, Ain Shams University, Cairo, Egypt Abstract In Saudi Arabia, as a result of using blood donation screening tests, the prevalence of CHC has decreased over the last decade. Moreover, the use of polymerase chain reaction (PCR) techniques as a screening tool for blood donors is likely to enhance the decrease in the rate of HCV transmission. Our biomarkers studied included liver function tests compare the HCV viral loads in the serum and six studied interleukins; IL6, IL9, IL10, IL22, IL33 and IFN-γ cytokines in the patient's group.Also, the study included a comparison between the liver function tests with cytokines levels in 57 patients CHC and 31 healthy control (HC). Interleukins showed different response toward CHC infection according to their percentage change concentration in pg/ml of plasma samples. These are as following: IL10 (33.9%), IL33 (30.0%0), IL6 (26.6%), IL9 (25.7%), IL22 (17.0%) and IFN-ɤ (2.4%). IL-33 had a decrease in its level up to 69.72 pg/ml in CHC group after treatment compared to that of HC group with 99.62 pg/ml. IL-33 was thus proposed to function as a novel alarmin (intracellular alarm signal released upon cell injury) to alert the immune system of tissue damage following trauma or infection. Moreover, levels of IL-33 serum correlated with the concentrations of ALT and AST in CHC patients. Plasma ALT and AST level were significantly higher in the CHC patient group than in the control group (54.8±48.1 IU/L vs. 33.4± 27.1 IU/L, p<0.009 and 50.3±45.5 IU/L vs. 27.5± 21.7 IU/L, p<0.002). IL6, IL9, and IL22 levels were found to correlated with treatment resistance to PEG-IFN/RBV therapy. Moreover, viral load had no correlation with patient's gender and age as well as with liver function tests (AST: 0.595, ALT: 0.882, ALP 0.232, DB: 0.362, GGT: 0.326, ALB: 0.829, TB: 0.469). In conclusion, the current study suggests that IL33 can use as an indicator for detecting the response of patients with CHC to combinational treatment to support the results of liver function tests and viral load and to detect the response of patients to therapy and the progression of the disease. Keywords Interleukin 33, HCV, Antiviral, Treatment 1. Introduction Chronic hepatitis C (CHC) is a global problem with a variable prevalence in different countries. It assessed that 140-170 million individuals chronically infected with the hepatitis C virus (HCV), and 3-4 million individuals have infected annually. HCV is one of the leading causes of end-stage liver disease and hepatocellular carcinoma (HCC). HCV transmission is an outcome of blood-borne infection, following the transfusion of infected blood products or the * Corresponding author: nagwa_aref.@hotmail.com (Nagwa Mohamed A. Aref) Published online at http://journal.sapub.org/cmd Copyright © 2016 Scientific & Academic Publishing. All Rights Reserved sharing of needles with HCV-infected individuals. The epidemiology of HCV among Arab is unique in its nature and a variety of risk factors associated with its high In prevalence rate [1-3]. A study in King Khalid University Hospital in Riyadh showed a decline in HCV prevalence rates in the blood bank database from 0.58% in 1996 to 0.08% in 2006 [4]. From 2000—2007, the incidence of all three viral hepatitis types HBV, HCV and HAV showed a 20—30% declining trend [5]. The dominant genotype in the KSA is genotype 4, followed by genotype one which is difficult to treat in comparison to genotypes 2 and 3. The combination of pegylated interferon (PEG-INF) and ribavirin for 48 weeks for genotypes 1 and 4 and 24 weeks for genotypes 2 and 3 is the current first-line. PEG-INF is effective in up to 70-95% of patients with genotypes 2 and