ABSTRACT
In some patients with persistent alteration of liver enzymes, the cause of [the disturbance cannot be established on the bases of clinical and analytical data. The significance and prevalence of occult viral infections in cryptogenic liver disease remains controversial. The aim of this study was to clarify our lack of knowledge about the exact pathogenic role of known hepatitis viruses in Egyptian patients with chronic unexplained elevation of serum transaminases. Seventy six patients with liver disease of unknown cause were enrolled in this study. In these patients the exact aetiology could not be defined from clinical, biochemical, and serological data. For every patient and before performing the liver biopsy, hepatitis B virus [HBV]-DNA, HCV-RNA and HGV-RNA were assayed in serum by polymerase chain reaction [PCR]. Liver biopsies from these patients showed non specific changes in 23.7%, fatty liver changes in 15.8%, chronic hepatitis in 48.7% and mixed cirrhosis in 11.8%. HBV-DNA and HCV-RNA were detected in serum of 11.8% and 32.9% of patients with cryptogenic disease respectively. Only one patient [1.3%] showed positivity for both viral genomes. Also, only one patient [1.3%] was found to be positive for HGV-RNA. Viraemia was found in 38.9% of patients with pathological non-specific changes, in 33.3% of those with fatty liver, in 51.4% of those with chronic hepatitis, and in 66.7% of subjects with mixed cirrhosis. The results of this study highlight the dominance of chronic viral hepatitis over other forms of liver disease in our country. Also, the routine use of PCR test will pick up most of missed cases of viral infection