Serum cytokine values and fatigue in chronic hepatitis C infection

Patients with chronic hepatitis C infection often experience fatigue, In ma ny clinical situations, an association between fatigue and altered serum cy tokine levels has been found. Altered cytokine levels in patients with hepa titis C have not shown a correlation with the degree of serum transaminase elevation or pathological change on liver biopsy, The aim of our study was to examine whether there was an association between abnormal serum cytokine levels and fatigue in patients with compensated chronic hepatitis C. Patie nts referred to a tertiary care hepatology clinic who were hepatitis C anti body positive and who had elevated alanine aminotransferase (ALT) levels we re eligible for entry into the study. A control group was also included. Su bjects in both groups who had characteristics other than hepatitis C that w ere known to alter cytokine values and/or cause Fatigue were excluded, Pati ents completed a validated questionnaire to determine their fatigue severit y score (FSS). Bioassays were used to measure interleukin (IL)-1, IL-6 and tumour necrosis factor-alpha (TNF-alpha) levels in early morning serum samp les taken from patients and controls. Altered cytokine values were defined as those more than two standard deviations above the mean control value. Da ta was analysed using SPSS, version 8.01. Of the 78 patients with chronic h epatitis C who participated in the study, 19 (24%), 24 (30%) and 45 (56%) h ad elevated levels of IL-1, IL-6 and TNF-alpha. respectively, compared with only two (6%) of the control group who had elevation of any of the three c ytokines. No correlation was found between the FSS and serum cytokine level s, when analysed singly or in combination, in patients with chronic hepatit is C. Hence, alteration in early morning serum levels of IL-1, IL-6 and TNF -alpha. in patients with chronic hepatitis C infection and elevated ALT lev els bear no correlation with the symptom of fatigue.