ABSTRACT
Patients with schistosoma haematobium display immune response may alter the outcome of HCV in-patients with concomitant HCV and schistosoma haematobium. This study was aimed at evaluation of the effect of immune response to schistosoma haematobium on the outcome of HCV in-patients with concomitant infection [HCV and schistosoma haematobium]. This study was conducted on 70 subjects 59 of them were infected with HCV and/or schistosomiasis selected form the outpatient clinic of El-Minya University Hospital while the remaining eleven subjects were healthy control volunteers with no history and negative serology to both HCV and schistosomiasis. The patients were grouped into three groups. Group [I] it included 24 patients with concomitant HCV and schistosomal infections. Group [II] it included 19 patients with schistosoma haematobium infection. Group [III] it included 16 patients with HCV infection alone and control group. It included 11 healthy subjects. All groups were subjected to history taking, clinical examination, abdominal ultrasonography and rectal snip were done for all groups and liver biopsy was done for HCV +ve patients. Routine laboratory investigations and ELISA assessed hepatitis markers [A, B, C] antibodies and Special investigations, CD3, CD4, CD8, and estimation of CD[4]/CD[8] ratio and detection of ant-bilharzial antibody titer. Absolute CD4 was highly significant higher in group 3 when compared to control group [p- value < 0.001] and was highly significant lower in group 1 when compared to control group [p- value < 0.001]. As regard to absolute CD4 between different groups of patient it was high in group 3 then less in group 2 and much lower in group 1 and these differences were highly significant [p- value <0.001]. Absolute CD8 was highly significant higher in group 3 when compared to control group [p- value < 0.001] and was highly significant lower in group 1 when compared to control group [p- value < 0.001]. As regard to absolute CD8 between different groups of patient it was high in group 3 then less in group 2 and much lower in group 1 and these differences were highly significant [p- value <0.001]. Absolute CD4 / CD8 ratio was highly significant lower in group 1, 2 and 3 when compared to control group [p-value < 0.001] and was highly significant lower in group 1 when compared to group 3 [p- value < 0.001]. As regard to absolute CD3, CD4, CD8 and CD4/ CD8 ratio absolute CD4 and CD4/CD8 ratio were higher in-patients treated with praziquantel versus those not receiving this medication. While CD8 was higher in-patients not received this medications versus those received the medications. This study has documented that schistosoma haematobium display a suppressive effect on the immune system so that a concomitant infection with HCV will present with a more protracted disease with severe sequel and adverse complications. Also this study has documented that CD4, CD8, and CD4/CD8 ratio may be good indicators of the disease activity. It is recommended that strict control and treatment of schistosomiasis may ameliorate the problem of HCV induced chronic liver disease in Egypt