title: Nitric oxide levels and sustained virological response to pegylated-interferon alpha2a plus ribavirin in chronic HCV genotype 4 hepatitis: A prospective study.
abstract: BACKGROUND
  The role of nitric oxide (NO) in infectious diseases is gaining attention because of its antiviral effects.
  
  
  OBJECTIVE
  To evaluate whether serum and hepatic NO levels are predictors of the outcome of treatment in patients with chronic hepatitis C genotype 4.
  
  
  METHODS
  Fifty six patients with chronic HCV genotype 4 treated with pegylated interferon (IFN) alpha-2a plus ribavirin underwent blood tests, assessment of serum level of NO and hepatic tissue expression of NO synthase (iNOS) before and during treatment.
  
  
  RESULTS
  The pre-treatment serum NO level was significantly higher in sustained responders (SR) [39.583 (35-43.8)] compared to relapsers [36.25 (26-43.8)], and non responders (NR) [35.417 (25.0-43.8)]. During treatment, the serum NO level was significantly higher in SR [58.125 (47.9-60.6)] compared to relapsers [53.854 (47.9-59.4)] and NR [50 (42.9-59.4)]. The pre-treatment iNOS expression was significantly higher in SR [37.5 (15-75)] compared with either relapsers [25 (15-45)] and or NR [20 (2-45)]. In multivariate logistic regression analysis, the serum NO was correlated with the virological response to pegylated interferon alpha-2a plus ribavirin therapy.
  
  
  CONCLUSIONS
  In patients with chronic hepatitis C, nitric oxide levels may be associated with the outcome of pegylated-IFN-α 2a plus ribavirin treatment.
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Minia University (61519) ,El Minia, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Wafaey
authors.initials: W
authors.lastname: Gomaa
authors.forename: Yehia
authors.initials: Y
authors.lastname: Ibrahim
authors.forename: Hazem
authors.initials: H
authors.lastname: El Hadad
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shatat
authors.forename: Ashraf Abdel
authors.initials: AA
authors.lastname: Aleem
authors.forename: Mohamed
authors.initials: M
authors.lastname: Essawy
authors.forename: Yasser M
authors.initials: YM
authors.lastname: Fouad
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D004359:Drug Therapy, Combination; D004534:Egypt; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007150:Immunohistochemistry; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000201:enzymology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D009569:Nitric Oxide; D011092:Polyethylene Glycols; D012254:Ribavirin; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II; C100416:peginterferon alfa-2a