THE STUDY OF THE EFFECT OF POLYMORPHISM (-607A/C) OF THE INTERLEUKIN-18 GENE ON THE PROGRESSION OF CHRONIC VIRAL HEPATITIS B AND CHRONIC VIRAL HEPATITIS B WITH A DELTA AGENT IN THE KAZAKH POPULATION
The 8-year experience of the transplant Centre in Almaty has shown that out of 146 recipients, 50 patients had cirrhosis and/or HCC in the outcome of chronic hepatitis D (CHB+D). The variation in clinical outcome of hepatitis B virus (HBV) infection is determined by virological, immunological and host genetic factors. IL-18 is suggested to play an important role in the development of chronic inflammatory diseases such as chronic viral hepatitis.The SNP in the IL-18 gene promoter at positions - 607 has a critical effect on the activity of the IL-18 gene. Objective. To study the association between single nucleotide polymorphism of the IL-18 gene promoter (-607A/C) and the progression of chronic HBV and HDV infection in the Kazakh population. Material and methods. The study included 115 patients diagnosed with CHB+D and 91 patients with chronic viral hepatitis B (CHB), as well as 100 healthy donors. The exams included: general clinical examination, biochemical analysis of blood, indirect liver elastometry, PCR for hepatitis B virus (HBV) and hepatitis delta virus (HDV), the levels of cytokines and profibrotic factors in blood serum were also determined, a genetic study to determine the polymorphism of the gene for intereleukin-18 (- 607C/A). Results and discussion. A/A genotype prevailed in the group of patients with CHB+D compared with the group of healthy donors (p = 0.001). The presence of A/A of the IL-18 promoter genotype (-607) in the group of patients with viral hepatitis B with a delta agent is statistically significantly associated with the stage of fibrosis (with cirrhosis, the chances of having A/A are 14.73 times higher (95% CI 1, 78-122.2). A positive correlation was found between the inheritance of allele A of IL18rs1946518 promoter and the presence of cirrhosis in patients with chronic viral hepatitis B with delta agent (P=0.020), as well as in the general cohort of patients (CHB and CHB+D) (p=0.019). Conclusion. The progression of fibrosis and the presence of cirrhosis in outcome of CHB+D in the Kazakh population is associated with the inheritance of the A/A genotype and the A allele of the IL-18 promoter (-607).