Fibro- alpha score as a simple and useful non-invasive test for predicting significant liver fibrosis in chronic hepatitis C patients

Non-invasive methods for the assessment of liver fibrosis are clinically important where hepatitis C virus [HCV] is common in Egypt. Our aim was to evaluate the diagnostic performance of a panel of simple blood markers of liver fibrosis in chronic hepatitis C [CHC] patients. A total of 199 patients with CHC evaluated for eligibility for antiviral therapy were included. Liver biochemical profile including transaminases, bilirubin, alkaline phosphatase, serum albumin, complete blood count prothrombin time and AFP were estimated. Liver biopsy was done. Statistical analyses were performed by logistic regression and receiver operating characteristic [ROC] curves to assess and compare diagnostic accuracy of blood markers. A stepwise combination algorithm was developed and validated prospectively in 135 additional patients. alpha-Foetoprotein [AFP] was the most efficient marker among other markers tested. The areas under the curves [AUCs] of AFP were 0.77 for significant liver fibrosis [F2-F4], 0.75 for advanced liver fibrosis [F3-F4] and 0.76 for liver cirrhosis [F4]. The stepwise multivariate discriminant analysis [MDA] selected a novel non-invasive index for discriminating patients with significant liver fibrosis, named Fibro- alpha score. Fibro- alpha score = [1.35 [numeric constant] +AFP [IU ml[-1]] x 0.009584 + aspartate aminotransferase [AST]/alanine aminotransferase [ALT] x 0.243 - platelet count [x10[9] I[-1]] x 0.001624]. The Fibro- alpha score was used for patients with advanced liver fibrosis and liver cirrhosis. The AUCs of Fibro-oc score were 0.82 for patients with advanced liver fibrosis and 0.80 for those with cirrhosis. These results were reproduced in a validation study with no significant difference. While liver biopsy is invasive, expensive and, in some settings, impossible to do, Fibro- alpha score is simple, cheap, non-invasive and may be useful for predicting significant liver fibrosis

Relation between T lymphocytes activities and the intensity of schistosoma mansoni infection

This study was done on 60 schistosome patients and 12 cross matched healthy control persons. The schistosome patients were classified on the bases of intensity of infection into: 22 patients with light infection [one to 100 eggs/gm stool], 24 patients with moderate infection [101- 400 eggs/gm stool], 14 patients with heavy infection [>400 eggs/gm stool]. All the studied cases were submitted to flow cytometric analysis of peripheral blood mononuclear cells using monoclonal antibodies against CD3, CD4, CD8, CD28, HLA-DR. It was found that there was a significant decrease in CD3, CD4 and the expression of costimulatory molecule CD28 on CD8 T lymphocytes, while CD8 T lymphocytes and the activation marker HLA-DR expression on CD4 T lymphocytes were increased. These changes were more obvious with the increase in intensity of infection