Prevalence of hepatitis C among adolescence in Sharkia governorate

Viral hepatitis C is a major worldwide problem. The present work aims at find out the prevalence of HCV infection among adolescences in Sharkia Governorate.The current work was carried out on four hundreds and fifty secondary and tertiary school adolescences including 237 males and 213 females with their ages ranged between 11-17 years. All studied adolescences were subjected to thorough medical history, clinical examination, blood sampling for liver function tests, HCV antibodies by 3[rd] generation ELISA and RT-PCR for detecting serum HCV-RNA for patients with anti-HCV +ve tests. It was found that nine out of 450 adolescences [2%] were HCV-antibody positive measured by 3[rd] generation ELISA, three of them [0.7%] had positive HCV-RNA when confirmed by RT-PCR. This study showed that there was a highly significant relation between blood transfusion, needle sticks and seropositivity for HCV antibodies. However, there was no significant relation between seropositivity for HCV antibodies and surgical operation. This study showed a statistical significant relation between seropositivity for anti-HCV antibodies and symptoms of viral infection as jaundice and dark urine, but not with right hypochondrial pain and other clinical signs as hepatomegaly, splenomegaly and lymphadenopathy. There was a significant change in the liver function tests [Total and direct bilirubin ALT, AST, ALP] in the seropositive adolescences but no correlation with total proteins and serum albumin. The family members of the nine positive adolescences were seronegative for HCV antibodies except two mothers who were positive by ELISA method. Also the liver function tests of the nine seropositive adolescences were normal except that of the ELISA and PCR positive mothers. The determination of the source of infection whether the mother infect their sons or vice versa cannot be assured as the mechanism of intrafamilial transmission remain enigmatic. HCV does not seem to play a major role in hepatitis among adolescences in Sharkia Govemorate. ELISA is a good negative screening test in low risk groups

Diabetes mellitus and hepatitis C virus: Is there a relationship?

This study was conducted on 80 patients with type 2 diabetes mellitus and 30 healthy control subjects in order to find out the relationship between HCV infection and diabetes mellitus. All cases and controls were subjected to full history taking, clinical examination, serological study of HCV antibodies by 3[rd] generation ELISA, HBsAg by ELISA, routine. Laboratory investigations, liver function tests, abdominal ultrasonography, diabetic biochemical profile [fasting and two hours postprandial blood glucose], glycosylated HbAIC and serum insulin level, serum anti-insulin antibodies and liver biopsy for 40 patients for histopathological examimition. The study showed that 49 out of 80 diabetic patients [61%] were anti-HCV +ve compared to controls [16.7%]. HBsAg was +ve in 4 cases only [5%]. Easy fatigability, swelling of both legs and abdominal distension were significantly more in anti-HCV +ve group. Shrunken liver, splenomegaly, ascites or lower limb oedema were the clinical signs that were significantly higher in anti-HCV +ve group. The aminotransferases [ALT, AST] showed significant increase, while serum albumin showed significant reduction in anti-HCV +ve group. Ultrasonographic study showed shrunken liver, periportal fibrosis, cirrhosis, portal vein dilatation, splenomegaly and ascites more in anti-HCV +ve group while bright liver was significantly more in anti-HCV -ve group. Liver biopsy showed that all cases of anti-HCV +ve group [23 cases] had chronic active hepatitis, 10 of them also showed cirrhosis while only one case had fatty change. In anti-HCV -ve cases [17 cases], 14 cases had chronic persistent hepatitis, 13 cases had fatty change, 2 cases showed chronic active hepatitis [they were HBsAg +ve] and one case had normal histology. This denotes that HCV infection leads to more severe and progressive pathological changes in diabetics. The biochemical pattern of diabetics showed that the 2 hours postprandial was the only parameter that had a significant difference between the two groups. So there is a delay in glucose consumption in patients with chronic HCV and this may be attributed to a defect in insulin action and this suggests that HCV could play a role in the development of diabetes. Serum insulin level was higher in anti-HCV +ve diabetics but not significant while HbAIC was lower. As regards anti-insulin antibodies there was no significant difference because only one case of anti-HCV +ve diabetics had it. This minimizes the role of auto immunity in the pathogenesis of diabetes in patients with HCV infection. In conclusion, we found a high prevalence of anti-HCV antibodies among diabetic patients. Therefore we suggest an association between them. The exact mechanism is not known, we suggest B-cell dysfunction [due to low insulin level], liver damage [because all anti-HCV +ve diabetics had severe histopathological hepatic changes] or defect in insulin action [because the 2 hours P.P glucose was significantly higher in anti-HCV +ve diabetics]. Further studies are needed to clarify the nature of the association and its exact mechanism

Evaluation of schisto-fast test in diagnosis of schistosomiasis

We conducted a prospective study to evaluate the Schisto-fast test as rapid method for diagnosis of active Schistosomiasis. Fifty patients with active Schistosomiasis were diagnosed by detecting Schistosomal eggs in stool, urine and rectal snips, fourteen persons infected with helminthes other than Schistosomiasis[to detect cross-reaction], and eighteen persons as a control group were included in the present study. Schisto-fast test and ELISA for detection of circulating antigen were done before and after anti-bilharzial therapy. The present study showed that Dot- ELISA test was positive in 100% and 68% in patients before and after anti-bilharzial treatment respectively, while ELISA test was positive in 96% and 16% in patients before and after treatment respectively. Also it was found that Dot- ELISA test was positive in 10/18 [55.6%] in normal control, and 57.14% [8/14] of infected control with other helminthes; while ELISA test was negative in normal control and positive in 14.29% [2/14] of the infected controls. It is our conclusion that the Dot- ELlSA test is not a reliable for diagnosis of Schistosomiasis, and ELlSA test can be used in detecting circulating Schistosomal antigen