Prevalence and Risk factors of overt- and occult Hepatitis C virus infection among Chronic Kidney Disease patients under regular Hemodialysis in Egypt

Background: hepatitis C virus [HCV] infection is a major health problem. It is more prevalent among chronic kidney disease [CKD] patients. Occult HCV infection, a new, entity has been described

Aims: to find out prevalence of occult HCV infection among CKD patients under regular hemodialysis [RHD] and to define epidemiology of HCV infection among them

Patients and Methods: a sample of 100 CKD patients under RHD was recruited. A questionnaire form was used to collect data. HCV-RNA was tested in serum to detect overt HCV infection patients. HCV-RNA was tested in peripheral blood mononuclear cells of undetected HCV-RNA patients' serum to determine those with occult HCV infection. Rest of the patients was considered HCV free. Biochemical tests were done to all patients

Results: prevalence of overt and occult HCV infection among CKD patients under RHD was 34.0% and 27.3%, respectively. Liver and renal function tests were significantly higher among the overt and occult HCV patients compared to negative HCV patients. Liver function tests were significantly lower among the occult compared to overt HCV patients. Overt HCV patients had significant risk factors compared to negative HCV patients; age group 40-59 years [OR=9.34] and rural residence [OR=3.14]. Also, significant clinical risk factors were the overweight, history of blood transfusion 5>/= times/year, history of nonmedical bloody manipulations, and history of IV drug abuse [OR=3.23, 5.96, 8.28, 7.08, respectively]. Occult HCV patients had significant risk factors compared to negative HCV patients; age group 60 >/= years and rural residence [OR=6.25 and 6.73, respectively]. Significant clinical risk factor was the history of nonmedical bloody manipulations [OR=11.5]

Conclusions and Recommendations: prevalence of overt- and occult HCV infection is high in CKD patients under RHD; this has important clinical and public health implications. There are many significant socio-demographic and clinical risk factors for these infections. A close monitoring of the HD patients and testing them for HCV-RNA in PBMCs yearly to adopted a proper management. Also, more studies on bigger number of patients are required to understand real epidemiology of this health problem

Maternal serum calcium and trace elments; copper and zinc among pre-eclamptic women in Cairo, Egypt

Low levels of blood calcium [Ca] and trace elements are observed in patients with pre-eclampsia [PE]. Among these patients low serum Ca, copper [Cu] and zinc [Zn] may be one of the disease causes. The aim of this study was to find out the serum biochemical profile of these elements in the studied pre-eclamptic women. A case-control, hospital based study design was used. All the cases and controls were examined laboratory. Maternal mean serum Ca, Cu and Zn were lower among pre-eclamptic cases compared to normal pregnant controls with statistically significant differences [P= 0.000 for each of them]. Further, maternal mean serum Ca, Cu and Zn were lower among the severe PE cases compared to the mild cases with statistically significant differences [P-0.002, 0.000 and 0.000, respectively]. Also, these low elements; Ca, Cu and Zn were significantly correlated factors with severe PE [P=0.01, 0.03 and 0.01, respectively]. Early ante-natal care and treatment for pre-eclamptic women are recommended. Ca, Cu and Zn supplementation may be a cost effective method to prevent PE. Prospective population based studies are needed in different areas in Egypt and on large number of pregnant women to determine possible PE risk factors