title: Serum Inter-Alpha-Trypsin Inhibitor Heavy Chain 4 (ITIH4) in Children with Chronic Hepatitis C: Relation to Liver Fibrosis and Viremia.
abstract: Liver fibrosis and viremia are determinant factors for the treatment policy and its outcome in chronic hepatitis C virus (HCV) infection. We aimed to investigate serum level of inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) and its relation to liver fibrosis and viremia in children with chronic HCV. ITIH4 was measured by ELISA in 33 treatment-naive children with proved chronic HCV and compared according to different clinical, laboratory and histopathological parameters. Liver histopathological changes were assessed using Ishak score and compared with aspartate transaminase-to-platelet ratio (APRI) and FIB-4 indices as simple noninvasive markers of fibrosis. ITIH4 was measured in a group of 30 age- and sex-matched healthy controls. ITIH4 was significantly higher in patients than in controls (54.2 ± 30.78 pg/mL versus 37.21 ± 5.39 pg/mL; P = 0.021). ITIH4, but not APRI or FIB-4, had a significant direct correlation with fibrosis stage (P = 0.015, 0.961, and 0.389, resp.), whereas, the negative correlation of ITIH4 with HCV viremia was of marginal significance (P = 0.071). In conclusion, ITIH4 significantly correlated with higher stages of fibrosis indicating a possible relation to liver fibrogenesis. The trend of higher ITIH4 with lower viremia points out a potential antiviral properties and further studies in this regard are worthwhile.
authors.affiliation: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, Shebin El-koom, Menofiya 32511, Egypt.
authors.forename: Mostafa M
authors.initials: MM
authors.lastname: Sira
authors.affiliation: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, Shebin El-koom, Menofiya 32511, Egypt.
authors.forename: Behairy E
authors.initials: BE
authors.lastname: Behairy
authors.affiliation: Department of Microbiology and Immunology, National Liver Institute, Menofiya University, Shebin El-koom, Menofiya 32511, Egypt.
authors.forename: Azza M
authors.initials: AM
authors.lastname: Abd-Elaziz
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Menofiya University, Shebin El-koom, Menofiya 32511, Egypt.
authors.forename: Sameh A
authors.initials: SA
authors.lastname: Abd Elnaby
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Menofiya University, Shebin El-koom, Menofiya 32511, Egypt.
authors.forename: Ehab E
authors.initials: EE
authors.lastname: Eltahan