Host genetic determinants in chronic hepatitis C virus infection in Egyptian patients

Mechanisms underlying viral persistence and liver damage in chronic HCV are not yet fully clarified, but a complex interplay of virological and immunological factors is implicated. An immunogenetic resistance or susceptibility to chronic hepatitis C virus [HCV] infection may contribute to the course of liver disease and may be linked to the human major histocompatibility complex [MHC]. This study was designed to study the distribution of the HLA class II alleles in patients with chronic hepatitis C and HCV-related cirrhosis to investigate whether these alleles might be associated with protection from or susceptibility to chronic HCV infection. We also aimed to address the correlation of the host HLA class II genotype with the lymphoproliferative response to phytohaemagglutinin [PHA] in vitro. The study included 60 unrelated patients with chronic hepatitis C [15 females, 45 males; mean age, 43 +/- 8.3 years]. A control group of 60 ethnically matched healthy blood donors was also studied [8 females, 52 males; mean age, 25 +/- 4.1 years]. HLA-DRB alleles were studied for patients and controls by a PCR-sequence-specific-primer low-resolution method. HLA-DRB1 03011 and HLA-DRB1 13011 were the most frequently distributed among HCV patients; their percentage of distribution were 26.8% and 28.3% respectively. Conversely, HLA-DRB1 07011 was found at significantly reduced frequency in HCV patients compared to that of the control group. The results also showed that the level of IFN-y was significantly increased in HCV patients [948.5 +/- 135.5] compared to that of the control group [193.6 +/- 21.26]. [t = 30.15, p

Role of infra-popliteal balloon angioplasty in the management of critical limb ischemia

The purpose of this study was to evaluate the patency rate and effectiveness of the percuatanous trans-luminal angioplasty [PTA] as a primary therapy for infra-popliteal occlusive disease. Twenty patients had angioplasty for Critical lower limb ischemia due to infra-popliteal disease between May 2005 - May 2007. We collected data on patient demography, symptoms, as will as pre and post procedure ankle - brachial pressure index [ABI] and angiographic findings. Thirteen men and 7 women had a mean age of 62 years. Risk factors included smoking in 70%, diabetes in 60%, hypertension in 40%, and end -stage renal disease in 1%. The indication for intervention were persistent rest pain in 50%, foot ulcer 30% and gangrene of foot or toes 20%. Immediate results were good in 19 patients with one case of technical failure .Three patients had restenosis at mean period of 7 months. There was one major and three minor amputations. Average follow up was11.2 months. The mean post procedural increase in ABI was 0.29. PTA of the infra-popliteal vessels has low morbiditiy, high success rate, and acceptable patency rate