ABSTRACT
Hepatitis C virus genotype 4 is a common infection in Egypt and is the leading cause of liver disease. Most reports suggest that predicative factors for the efficacy of interferon alpha and ribavirin combination therapy for chronic hepatitis patients could be due to the mutations in the interferon sensitivity determining region. The present study aimed to investigate the predictive factors for combined pegylated interferon-alpha and ribavirin therapy for chronic hepatitis patients with HCV genotype 4. The study was carried out on forty patients with genotype 4 chronic hepatitis C receiving a weekly dose of 180 microg of PEG -IFN-alpha in combination with RBV for 48 weeks. HCV RNA serumviremia levels were determined by a real-time polymerase chain reaction. The RNA samples were genotyped using specific primers for HCV genotype 4, and the interferon sensitivity determining region was amplified using polymerase chain reaction and sequenced. The amino acid sequence of the ISDR was compared with the published sequence for HCV 4 [GenBank: ABD75831.1]. Our data revealed that twenty one patients were responders [R; 52.2%], whereas 19 patients showed no-response [NR; 47.5%] to the combined pegylated interferon-alpha plus ribavirin therapy. The values of RNA titer in both responder and non-responder groups were statistically significant and could be used a predictive factor for combined pegylated interferon -alpha plus ribavirin efficacy. Other factors, such as gender, age, and interferon sensitivity determining region subtype were not related to its efficacy. These data collectively suggest that HCV RNA titer is an important factor for predicting the efficacy of pegylated interferon alpha plus ribavirin combination therapy in Egyptian patients with chronic HCV genotype 4
ABSTRACT
Transfusion-transmitted viral infection is present worldwide among blood donors. In the present study prevalence of early acute HBV infection among the eligible blood units for donation was investigated. Sera [760] from Egyptian blood donors [636 [83.68%] males and 124 [16.32%] females], who met donor selection criteria, were routinely screened for HBsAg, HCV-Ab, HIV 1/2-Ab and Syphilis-Ab. Accepted blood units for donation were further tested for liver and kidney functions and the presence of HBc-IgM and HBV-DNA. Screening resulted in 38 [5%] HCV-Ab positive units, 9 [1.18%] HBsAg positive units and one [0.13%] Syphilis-Ab positive unit. Testing of the accepted units for donation [712, 597 [83.84%] male and 115 [16.16%] female] resulted in one [0.13%] HBc-IgM positive unit and 2/30 HBV-DNA positive units. The routine screening of blood unit, to some extent, discovered the current viral infection but failed to detect early acute or window HBV infections where HBsAg is absent. ALT and AST levels were not indicative in viral infection in accepted blood donors at window period. Our study suggests that sensitive methods for detection of HBV [e.g. PCR] may be recommended in screening of donated blood. Anti-HBc antibody should be tested routinely on all donated blood units