Date Published: June , 2018
Publisher: Makerere Medical School
Author(s): Shehab M Abd El-Kader, Osama H Al-Jiffri.
Recently, about 2.35% of the world populations are estimated to be chronically infected with hepatitis C virus (HCV). Previous cohort studies indicated that obesity increases risk of hepatic steatosis and fibrosis in non-diabetic patients with chronic hepatitis C infection due to diminished response to anti-viral therapy and as a result obesity is considered as an important factor in the progression of chronic HCV. However, there is a strong association between BMI and the human immune system among HCV patients.
This study aimed to examine effects of weight reduction program on selected immune parameters among HCV Saudi patients.
One-hundred obese Saudi patients with chronic HCV infection participated in this study, their age ranged from 50–58 years and their body mass index (BMI) ranged from 30–35 kg/m2. All Subjects were included in two groups: The first group received weight reduction program in the form of treadmill aerobic exercises in addition to diet control whereas, the second group received no therapeutic intervention. Parameters of CD3, CD4 and CD8 were quantified; Leukocyte, differential counts and BMI were measured before and after 3 months, at the end of the study.
The mean values of BMI, white blood cells, total neutrophil count, monocytes, CD3, CD4 and CD8 were significantly decreased in the training group as a result of weight loss program; however the results of the control group were not significant. Also, there were significant differences between both groups at the end of the study.
Weight loss modulates immune system parameters of patients with HCV.
Globally, an estimated 180 million people are chronically infected with HCV and 3 to 4 million are newly infected each year1,2. Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide3 and persistent infection occurs in 50 to 80% of those infected and may lead to the development of cirrhosis and subsequent hepatocellular carcinoma1.
The demographic and clinical characteristics of the subjects are shown in Table 1. There were no significant differences between both groups regarding age, height, albumin, fasting blood glucose, hemoglobin, total bilirubin, systolic blood pressure, diastolic blood pressure, body weight, body mass index (BMI), waist circumference, fat mass, alanine aminotransferase (ALT) and HCV viral.
The best immune correlate of HCV control is a strong and broad CD4+ T-cell response to HCV antigens, which is often associated with an equally robust and broad HCV specific CD8+ T-cell immune response36–38. It is believed that CD4+ T cells are necessary to ensure fully functional CD8+ T-cell responses, which then can clear the virus39. However, obesity is associated with the modulation of immune parameters40,41. To our knowledge, this is the first study of immune function measures in relation to previous intentional weight loss in HCV patients. Our results indicate that there may be long-term effects of intentional weight loss on immune function. These results are in line with several previous studies.
The current study provides evidence that weight loss modulates immune system parameters of patients with HCV.