Chronic hepatitis C in children: clinical spectrum and histopathological study

Hepatitis C virus [HCV] is a major public health problem and a leading cause of chronic liver disease. An estimated 180 million people are infected worldwide. The prevalence of hepatitis C virus [HCV] infection is relatively low in children, with an anti-HCV prevalence rate of 0.2-0.4% in the Western world. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15-25% in rural communities. The main [90%] HCV genotype is type 4. The magnitude of HCV infection in children is not well studied. Asymptomatic HCV infection is detectable in 2.02% of Egyptian children. To study the clinical presentation and histopathological features of the liver in children with chronic hepatitis C infection. The study population included 40 children from 2 to 16 years who had been diagnosed with chronic hepatitis C [HCV-RNA positive for 6 months or more by Real-time PCR] in the liver clinic at El-Shat by Children Hospital. Among the 40 patients' biopsies, 26 [65%] were stage 0, 10 [25%] were stage 1, 4 [10%] were stage 2-3 [HAI]. The grades of all 40 children ranged between 0 and 1 [HAI]. Developing fibrosis was significantly associated with age [P =0.015]. Children with chronic HCV infection are generally asymptomatic. Significant hepatic fibrosis was present in 10%of children with HCV infection. Fibrosis stage was significantly higher in older age children. There was no significant association between fibrosis stage and any biochemical parameter

Experimental trichinosis: parasitological, electrophysiological and biochemical studies

Trichinosis is a parasitic infection affecting the gut and the muscles causing mild gastrointestinal symptoms followed by periorbital oedema, muscle pains, fever and eosinophilia. The infection evokes functional disturbances in physiological effector systems. Furthermore, several biochemical changes are associated with the infection. Therefore, this work was carried out to study the electrophysiological changes in intestine, striated and cardiac muscles by electromyography [EMG] and to assess the biochemical changes through measurement of serum cholinesterase and intestinal myeloperoxidase activity [MPO] in both light and heavy infected experimental animals by Trichinella spiralis [T. spiralis]. Electrophysiological results showed increased contractility of the smooth muscle layers of the intestine only early in the infection, whereas both striated and cardiac muscles showed increase in the contractility with the progress of infection in both light and heavy infection. Significant myocardial dysfunction in the form of bradycardia, in addition to major histopathological changes in the heart occurred from the beginning of the infection and increased till the end of the study. Biochemical study showed gradual increase in serum cholinesterase, while, the intestinal MPO showed increase only in the early stage of the infection. It was noticed that all changes were more pronounced in the heavily infected group than the lightly infected one

Vaccination trial against experimental trichinellosis using autoclaved trichinella spiralis larvae vaccine [ATSLV]

The autoclaved Trichinella spiralis larvae vaccine [ATSLV] was tested and showed unpredictable effect on the immune system of mice experimentally infected with T. spiralis. The vaccine was given with Bacillus Calmette-Guerin [BCG] as an adjuvant at different durations and by different routes of administration. The best result was achieved by given the vaccine twice intradermally with two-week interval as evidenced by a significant reduction in adult and larval count, as well as reproductive capacity index. Histopathologically, there was a significant reduction in the number of the encysted larvae, which showed degeneration and hyalinization of the cyst wall accompanied by early pericystic fibrosis

possible antifibrotic effect of theophylline, diltiazem, deferoxamine and minoxidil on the development of murine schistosomal hepatic fibrosis

The effects of theophylline, diltiazem, deferoxamine and minoxidil with and without praziquantel [PZQ] were tested on Schistosoma mansoni infected mice to investigate their possible effect on the progression of hepatic granulomatous reaction into fibrosis in murine schistosomiasis. 66 male Swiss strain albino mice were used in the study. They were divided into 4 groups; control group; infected and treated with PZQ [1000 mg/kg/day] orally for two successive days; infected and treated for 2weeks with deferoxamine [25 mg/kg/day], diltiazem [24 mg/kg/day], theophylline [30 mg/kg/day], or minoxidil [1.0 mg/kg/day]; infected and treated with each of the previous drugs combined with PZQ. At the 10[th] week postinfection, animals were subjected to splenic pulp pressure measurement. The pathological changes in the liver were examined by routine H and E and Masson Trichrome stains. Livers were examined for egg count, granulomas number and size. Liver collagen deposition was also determined. Statistical correlation of the results was done. Praziquantel significantly reduced liver egg count, granulomas number and size. It decreased liver fibrosis assessed histopathologically, liver collagen content and portal venous pressure but not to significant levels. None of the tested drugs [deferoxamine, theophylline, diltiazem, or minoxidil] succeeded to reduce schistosoma egg deposition or granulomas number and size in livers of schistosoma-infected mice. However, significant reduction in these parameters was achieved only when PZQ was added to the treatment regimen. Deferoxamine, theophylline, and minoxidil significantly decreased level of hepatic fibrosis, collagen deposition and portal venous pressure. These effects were significantly augmented when PZQ was combined with any of these drugs. Diltiazem alone or in combination with PZQ failed to decrease liver collagen content or hepatic fibrosis induced by schistosoma infection. However, diltiazem alone or in combination with PZQ could significantly reduce portal venous pressure. Accordingly, it is recommended to extend this animal study to human to investigate the possible mitigation of the deleterious effects of schistosomiasis on the liver by the addition of deferoxamine, theophylline, or minoxidil to its treatment regimen. Diltiazem can also be used to reduce portal venous pressure

novel macrolide in mixed protozoal infection in immunosuppressed mice

As the number of immunocompromized patients is increasing, there will be an increasing need for a reliable therapy efficacious against the opportunistic intestinal protozoa. The present work aimed to study the efficacy of azithromycin as a single weapon directed against mixed intestinal protozoal infection induced in immunosuppressed mice. In the infected treated group of mice, there was a marked amelioration of the pathological changes provoked by the four parasites Cryptosporidia, Enterocytozoon bieneusi, Giardia lamblia and Entamoeba histolytica. As long as the mice were receiving azithromycin, there was a significant reduction of all parasitic stages with the complete absence of spore forming protozoa. One week after the drug was stopped Giardia lamblia and Entamoeba histolytica stages were progressively reduced but oocysts of cryptosporidia and spores of Entercytozoon bieneusi reappeared in situ. Azithromycin therapy should be continued as long as the individual is immunosuppressed