الفهرس 
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Abstract
IL-18 play a prominent role in liver injury. It exerts its pro inflammatory activity by enhancing the Fas ligand- and perforin-mediated T-cell and NK-cell cytotoxicity, stimulating Th1-cell development, inducing chemokines, and decreasing IL-10 expression in T cells. It also increases the susceptibility of liver endothelial cells to undergo apoptosis.
The present study aimed to evaluate serum IL-18 levels in chronic HCV related liver diseases and to determine the possible relation between serum IL-18 and development of hepatic decopensation and/or complications in these patients.
The present study was conducted on 60 patient with HCV related chronic liver diseases selected from Tropical Medicine Department, Menoufiya University Hospital, during the period from January to March 2014. They were 39 males (65%) and 21 females (35%) with a mean age of 50.66 ± 7.76 years patients only. In addition 10 healthy subjects of matched age and sex were selected as control group. Patient and control were classified into the following groups: G I: Included 20 patients with chronic patients with Included 20 patients with chronicpatients with chronic patients with chronicpatients with chronic patients with chronicpatients with chronicpatients with chronicpatientschronic HCV HCV HCV related no related no related no related norelated norelated non complicated complicatedcomplicatedcomplicatedcomplicatedcomplicated complicated liverliverliverliver cirrhosis cirrhosis group.
An informed written consent was obtained from all the studied patients & control. They were subjected to: Detailed history taking, thorough clinical examination, laboratory investigations including liver profile tests (ALT, AST, bilirubin, serumalbumin and INR), viral markers (HCV antibody, HBsAg), PCR, serum alpha-fetoprotein, imaging study (abdominal
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ultrasonography and triphasic CT scan) and measurement of serum Interleukin (IL)-18.
Exclusion criteria: Patients with chronic liver diseases due to any cause other than chronic HCV and patients with any disease known to affect serum level of IL-18 (chronic infection, diabetes mellitus, renal failure, coronary heart disease, other malignancies, etc) were excluded from the present study.
The results of the present study revealed the following data:
There were no significant difference among studied groups as regarded age and sex distribution.
General manifestations of liver cirrhosis were present in various proportions in G II and G III patients and some manifestations might be consistent clinically with HCC.
Local manifestations of liver cirrhosis were present in various proportions in G II and G III patients.
Abdominal ultrasonography revealed the presence of imaging evidences of cirrhosis in G II & III in various proportion and the presence of focal hepatic lesion(s) in some patients of G III.
There were highly significant decrease in the mean values of serum albumin, highly significant increase in the mean values of serum bilirubin and INR in G II and G III patients in comparison with other groups. Significant decrease in the mean values of serum albumin in G II in comparison to G III. Significant increase in the mean values of serum INR in G III in comparison to G II. Significant increase in the mean values of serum ALT in G I, II & III in comparison to G IV. Highly significant increase in the mean values of serum AST in G II
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& III in comparison to G IV, in G II in comparison to G I and there was significant increase in the mean values of serum AST in G III in comparison to G I.
There were highly significant increase in the mean values of serum IL-18 in G II and G III patients in comparison to G I and G IV patients and highly significant increase in the mean values of serum IL-18 in G III patients in comparison to G II patients.
There were highly significant increase in the mean values of serum IL-18 in decompensated liver cirrhosis patients in G II patients when compared to compensated patients.
There were highly significant positive correlation between Child-Pugh score and serum IL-18 level in G II patients.
Statical analysis revealed highly significant increase in the mean values of serum IL-18 in cirrhotic patients complicated by HCC followed by cirrhotic patients complicated by HRS.