Assessment of immunological changes in Epstein-Barr virus co-infection in Egyptian chronic HCV patients

Epstein-Barr virus (EBV) plays a major role in liver pathology. Similar to other members of the herpesvirus
family, EBV establishes a persistent infection in more than 90% of adults. The aim of this study was to evaluate the
impact of EBV and chronic hepatitis C co-infection (HCV) on biochemical and immunological responses in patients.
The study was conducted in 62 patients and 33 apparently healthy controls. Patients were divided into three groups:
group I, consisting of 31 patients with chronic hepatitis C infection (CHC), group II, consisting of eight patients with
EBV infection and without HCV infection and group III, consisting of 23 patients with EBV and chronic HCV. The
percentage of CD3+cells, helper CD4+ cells and CD19+ B-cells was measured by flow cytometry. Human interferon-γ
(IFN-γ) and interleukin (IL)-15 levels were measured by an ELISA. The levels of liver alanine aminotransferase and
aspartate aminotransferase enzymes were higher in EBV/HCV patients compared to that in EBV and HCV monoinfected patients. EBV/HCV patients had significantly reduced percentages of CD3+ and CD4+ cells compared to
EBV patients. Serum IFN-γ levels were significantly reduced in EBV/HCV patients (3.86 pg/mL) compared to CHC
patients (6.76 pg/mL) and normal controls (4.69 pg/mL). A significant increase in serum IL-15 levels was observed in
EBV/HCV patients (67.7 pg/mL) compared to EBV patients (29.3 pg/mL). Taken together, these observations suggest
that HCV and EBV co-infection can potentiate immune response dampening in patients.