Sexual dysfunction in males with hepatitis C virus: relevance to histopathologic changes and peginterferon treatment

The frequency of sexual dysfunction [SD] is not well known in patients with chronic hepatitis C virus [HCV]. In spite of the fact that histological benefits of peginterferon [Peg-IFN]/ribavirin therapy are well established, the effects on sexual health are less certain. To assess the prevalence of the SD and explore its relevance to histopathologic changes and Peg-IFN treatment. The study included 100 HCV males; all the patients completed questionnaires to assess their sexual function before and during the treatment. Before treatment, SD was reported only by 12 [19.4%] and 10 [29.4%] patients of early and advanced liver fibrosis, respectively. SD during HCV treatment [with Peg-IFN and ribavirin] for liver fibrosis was significant, as 24 [70.6%] out of 34 [100%] of HCV patients had advanced fibrosis but only 20 [32.3%] out of 62 [100%] patients had early fibrosis and were sexually affected [P = 0.01]. SD before treatment was found in 22 [22%] patients; 16 [16%] were >40 years old and 6 [6%] patients were

Relationship between HCV infection and Insulin resistance in non-obese non-diabetic patients

Hepatitis C is a major cause of liver-related morbidity and mortality and represents a major public health problem in Egypt and worldwide. There is growing evidence as regard to the association between hepatitis C virus [HCV] infection and type 2 diabetes mellitus. However, the mutual link and related virological implication have not been fully clarified. Insulin resistance [IR] plays a primary role in the development of type 2 DM. This is supported by the results of prospective longitudinal studies showing that IR is the best predictor of the development of type 2 DM, preceding its onset by 10-20 years. To assess the correlation between HCV morbidity and Insulin resistance [IR] detected by HOMA test in none diabetic none obese HCV patients. The study participants were subcategorized into two groups,Group [I]: included 867 healthy subjects [negative HCV RNA] as a control group. Group [II]: included 277 patients with chronic HCV as a study group. The 2 groups were subjected to thorough history taking, full clinical examination, Anthropometric study,ultrasonographic examination and laboratory investigations including liver functions, viral markers, and qualitative PCR for HCV RNA ,lipid profile, glucose profile and HOMA test. This study revealed higher insulin resistance in the HCV study group than the control group

Detection of visceral adiposity by ultrasonography and its relation to insulin resistance in HCV patients

Hepatitis C is a major cause of liver-related morbidity and mortality and represents a major public health problem in Egypt and worldwide, Ultrasonography is a simple non-invasive method for detection of visceral fat, which is directly, correlated with insulin resistance [IR] as well as development of type 2 diabetes mellitus. To assess the validity of detection of visceral adipose tissue area with Ultrasonography and its correlation with IR in HCV patients. The study participants were subcategorized into two groups, Group [I]: included 867 healthy subjects with negative [HCV] RNA as a control group. Group [II]: included 277 patients with chronic HCV as a study group. The 2 groups were subjected to thorough history taking, full clinical examination, Anthropometric study,ultrasonographic examination and laboratory investigations including liver functions, viral markers, and qualitative PCR for HCV RNA ,lipid profile and glucose profile. This study revealed that Ultrasonography is a simple, non-invasive, safe method in detection of visceral adiposity, which is correlated significantly with IR in chronic HCV patients

Laparoscopic cholecystectomy in liver cirrhosis patients: an Egyptian experience

Cirrhosis represents a common histologic pathway for a wide variety of chronic liver diseases. Hepatitis C virus [HCV] is the most important cause of liver cirrhosis in Egypt. Although cirrhosis has been regarded as a relative contraindication for laparoscopic cholecystectomy [LC] due to bleeding complications and subsequent liver failure, several reports support the safety of LC in selected patients. A prospective study to evaluate the efficacy and safety of laparoscopic cholecystectomy in cirrhotic patients. 177 hepatitis C positive patients with chronic calculus cholecystitis, scheduled for cholecystectomy, were included in this study between Jan. 2009 and Mar. 2010 where laparoscopic cholecystectomy was performed to them after fulfilling the inclusion criteria. Two risk stratifications schemes have been used to estimate the perioperative risk of patients with cirrhosis; the Child-Turcotte-Pugh [CTP] score and the Model for End-stage Liver Disease [MELD] score. 177 liver cirrhosis patients with chronic calcular cholecystitis scheduled for LC represented the population of this study. All patients were HCV positive patients with Child A class cirrhosis and MELD score < 9. Mean surgical time: 55 minutes, surgical difficulty varied between average in 64%, moderate in 28% and extensive in 8% where 3.4% needed conversion to open cholecystectomy. Postoperative follow up of all cases was multidisciplinary approached by both surgeons and hepatologists. All cases showed sound recovery confirmed by abdominal sonar to exclude intra-abdominal collections and application of both CTP and MELD scores, where all cases kept class A Child score and MELD score < 9. Laparoscopic cholecystectomy is a safe procedure for hepatitis C positive cirrhotic patients when established risk stratifications systems such as CTP and MELD scores are used for evaluation