ABSTRACT
Hepatitis C virus [HCV], being both a hepatotropic and lymphotropic virus represents a chronic stimulus for the immune system. So, various extra hepatic immunologic abnormalities have been shown to occur frequently in patients with chronic hepatitis C virus. Among the systemic manifestations of chronic HCV infection, lung involvement has been described. Also the possibility that HCV infects extra hepatic cells has been widely discussed. So we aimed in this study to detect HCV antigen in the bronchial mucosa and broncho-alveolar lavage [BAL]. Together with, the study of histopathological changes in the bronchial biopsy and the cellular content of the BAL in patients with chronic HCV infection.Our study included 50 patients suffering from chronic liver disease due to Hepatitis C virus infection complaining of recurrent cough with negative clinical chest finding and normal X-ray chest.The patients were subdivided into: three groups according to Child-pugh classification.Bronchoalveolar lavage and bronchial biopsy were obtained through the use of fibre optic bronchoscopy. And detection of HCV antigen in the BAL and biopsy using immunohistochemistry was done. Alsostudy of the histopathological changes of bronchial biopsy and lavage were performed
In our results, HCV in bronchial biopsy and BAL fluid was detected in 42% [21/50] of our patients. And BAL showed increase in the neutrophils and lymphocytes percentage especially in patients in group II "Child B".Pulmonary permeability is mostly affected in cases of HCV infection, noticed by increase of the albumin level in the BAL of patient of Child "C" [group III]. Also Variable degrees of pathological changes have been noticed in the bronchial mucosa of the patients. These variations are affected by the severity of liver disease.So we conclude that the presence of inflammatory cell infiltration together with pathological changes of the bronchial mucosa may induce bronchial inflammation as a sequel of HCV infection which could explain the occurrence of the recurrent cough in our patients, and may lead to progressive fibrosingalveolitis