ABSTRACT
This study was carried out on 100 schistosomal patients and 20 apparently healthy individuals served as control. The schistosomal cases were divided into 3 groups. GI, 45 cases with early intestinal schistosomiasis, GII, 30 cases with hepatosplenomegaly, GIII, 25 cases with hepatosplenomegaly and ascitis. All cases and control group were subjected to careful history taking, clinical examination, stool examination by modified formol ether concentration technique, proctosigmoidscopy and rectal snip for non egg passers [ascitic group], detection of antinHCV antibodies and HBsAg by MEIA technique. Evaluation of liver functions [ALT, AST and serum albumin] and liver biopsies were taken to study ultrastructural changes by electron microscope. The results revealed that all schistosomal cases were negative for HBsAg while 5% of control group were positive for HBsAg and the difference was statistically high significant. The antinHCV antibodies were detected in 40% of schistosomal cases and in 20% of control group and the difference was statistically insignificant. The antin HCV antibodies were detected in 11.1% of group I, in 53.3% of group II and in 76% of group III and the difference was statistically high significant. Examination of liver biopsies by electron microscope showed that in case of intestinal schistosomiasis there was normal hepatocyte. In case of intestinal schistosomiasis and HCV coinfection there were moderate irregularity of nuclear shape, moderate chromatin condensation on the inner surface of nuclear envelop, prominence of nucleolus and has eccentric position, saccular dilatation of endoplasmic reticulum, moderate mitochondrial ballooning and normal intercellular space. In case of late stage of schistosomiasis and HCV coinfection there were marked fibrosis and collagen deposition, marked irregularity of nuclear envelop, marked condensation of chromatin on the inner surface of nuclear envelop, prominent nucleolus, marked ballooning of mitochondria and loss of its cristae and saccular dilatation of endoplasmic reticulum. The author concluded that patients coinfected with schistosomiasis and HCV were characterized by more severe liver disease