TUMOR NECROSIS FACTOR-α AND LIVER FIBROSIS IN CHRONIC HEPATITIS B AND C PATIENTS BELONGING TO DIFFERENT POPULATION GROUPS IN KAZAKHSTAN

Objective. To estimate the pathogenetic and possible criterion values of tumor necrosis factor-α (TNF-α) in the risk of poor outcomes of chronic hepatitis B and C (CHB, CHC), by taking into account patients’ ethnicity. Subjects and methods. Blood TNF-α levels were measured at an interval of 48 hours and liver biopsy specimens were examined in 230 ethnic Kazakh (Group 1) and Slavic (Group 2) patients with CHB and CHC. Results. All the patients were divided into 2 groups according to the serum TNF-α level: 1) >87 pg/ml and 2) ≤ 87 pg/ml. At the F1 stage, a high TNF-α level was prevalent in Group 1. At the other stages, the proportion of patients with a high TNF-α level increased with more severe fibrosis and did not depend on ethnicity. In Group 1, the rate of TNF-α growth was, in terms of the stages of liver fibrosis, significantly higher than that in Group 2. Conclusion. In Group 1 patients, blood TNF-α level and rate of its increase were significantly higher than those in Group 2 patients; their genetic traits being, to the largest extent, manifested at the F1 stage of liver fibrosis and unassociated with the etiology of viral hepatitis. In CHB and CHC, the rate of TNF-α elevation significantly correlated with that of liver fibrosis development and the TNF-α level of >87 pg/μl allowed the risk of progressive hepatitis to be predicted.

chronic hepatitis B, chronic hepatitis C, tumor necrosis factor-α, liver fibrosis, Kazakh ethnicity, Slavic ethnicity