Background: Hepatitis C virus (HCV) infection is a major global health problem and a leading cause of chronic liver disease. Viral load assessment by real-time polymerase chain reaction (RT-PCR) is the standard method for diagnosing active infection and predicting therapeutic outcomes. Immunological pathways, particularly Toll-like receptors (TLRs) and pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), may play a role in disease progression and chronicity. This study aimed to evaluate the prognostic significance of Toll-like receptor-4 (TLR-4) and TNF-α levels in patients with HCV infection and to assess their association with viral load. Methods: A case–control study was conducted at the Babylon Gastrointestinal and Liver Center from January to September 2023. Fifty patients with confirmed HCV infection were compared with 50 apparently healthy individuals. Diagnosis was established by positive screening tests and confirmed using HCV RNA quantification via RT-PCR. Serum levels of TLR-4 and TNF-α were measured, and statistical analysis was performed using SPSS software. Results: Most patients exhibited a low viral load, with a higher proportion of females affected than males. A statistically significant decrease in TLR-4 levels and a significant increase in TNF-α concentrations were observed in HCV patients compared with controls. These findings suggest an altered immune response associated with HCV infection. Conclusion: Viral load assessment, together with immunological markers such as TLR-4 and TNF-α, may provide valuable insights into disease prognosis and management in HCV patients. Reduced TLR-4 and elevated TNF-α levels may be associated with disease progression and liver damage. Further large-scale studies are recommended to explore their role in predicting cirrhosis and long-term outcomes.
*1Raheem Tuama Obayes Al –Mammori, 2Marwan Hamid Al- Alwany, 3Ammar Malik Dokhin (Sat,) studied this question.