ABSTRACT
It has been recently hypothesized that the hepatitis C virus [HCV] might be involved in the pathogenesis of lymphoproliferative disorders [LPD], systemic lupus erythomatosus [SLE], nephrotic syndrome and renal failure [RF]. The aim of this study is to determine the prevalence of HCV infection among immunocompromised patients and a trial to assess the sensitivity of HCV core antigen [HCVcAg] testing as a screening method compared to PCR-RNA in these patients. The study included 75 patients with malignant lymphoproliferative disease [LPD] under long term chemotherapy including immunosuppressive therapy [30 children and 45 adults] [group II], 46 chronic renal failure patients under hemodialysis [10 children and 36 adults] [group III], 20 systemic lupus erythematosus patients [SLE] under long term immunosuppressive therapy [10 children and 10 adults], group IV and 30 nephrotic syndrome patients under long term immunosuppressive therapy [20 children and 10 adults] [group V]. Thirty healthy subjects were included as controls [group I]. HCV detection by HCV-antibodies, HCVcAg and HCV PCR were done for all patients and controls. The results showed that there was significantly increased prevalence rates of HCV infection among immunocompromised patients. Positivity was 53.33% in LPD group, 47.83% in chronic renal failure group, 45% in SLE group and 33.33% in nephrotic syndrome group. Also our results revealed that, in studied patients [children and adults], HCVcAg in comparison to PCR had diagnostic sensitivity of 100%, specificity of 98.38%, accuracy of 99%, positive predictive value of 97.53% and negative predictive value of 100%. [1] immunocompromised patients have a higher prevalence rate of HCV infection. [2] increased prevalence were significantly higher in patients with non-Hodgkin's lymphoma [NHL], membranoproliferative glomerulonephritis [MPGN] and with the increased duration of hemodialysis in patients with chronic renal failure. [3] HCV infection may play an important role as a risk factor in both lymphoproliferative disorders, and clinical pattern of SLE. [4] HCVcAg maybe considered as an alternative to HCV-RNA assay in screening of HCV infection