Immunological Aspects of ELISA Positive PCR Negative Newly Diagnosed Hepatitis C Patients in Kirkuk Province

This study was conducted in Kirkuk city from June 2018 to March 2019. The number of hepatitis patient understudy were 40 newly diagnosed hepatitis C whose ages were between 20-75 years old. The purpose of this study was to evaluate the effect of interleukin (IL)-23 and IL-27 in the clearance of HCV in the first months of infection. The control group who were matched to the patients studied, included 40 individuals who admitted to the blood bank for blood donation, for the molecular test of HCV Real-time quantitative test and serum IL23 and IL-27 by ELISA and biochemical estimation if liver function tests. The study demonstrated that 75 % of patients with acute hepatitis C who had anti-HCV as detected by ELISA revealed positive results by RT-PCR and 25% yield negative result by RT-PCR. The study showed that 66.67% (21 of 30) of PCR + acute hepatitis patients C were infected by genotype 4 of HCV. Regarding the relation of IL-23 with HCV infection, the present study showed that the highest mean of IL-23 level was recorded among PCR –ve patients with acute hepatitis C (23.8 pg/ml) followed by PCR +ve patients with acute hepatitis C (14.7 pg/ml) and the lowest means were found in the control (4.6 pg/ml) group with highly significant differences among the groups. The present study showed that the highest mean of IL-27 level was recorded among PCR –ve patients with acute hepatitis C (35.7 pg/ml) followed by PCR +ve patients with acute hepatitis C (20.5 pg/ml) and the lowest mean was found in the control group (11.9 pg/ml) with highly significant differences. The study showed a strong negative correlation of IL-23 and IL-27 with viral load and ALT in patients with acute hepatitis C. IL23 and IL-27 levels were increased significantly in HCV patients with –ve PCR result. It was concluded that the increased levels of IL-23 and IL-27 in PCR negative hepatitis patients refer to the good immune response of patients toward the virus and HCV ELISA positive patient does not necessarily have viral hepatitis C.