ABSTRACT
The progression of hepatitis C virus [HCV] positive liver disease from hepatitis to cirrhosis and hepatocellular carcinoma [HCC] involves factors other than the virus itself. An etiologic agent capable of inducing chronic active hepatitis and hepatocellular tumors in mouse was discovered belonging to the genus Helicobacter, and was named Helicobacter Hepaticus. Several research have reported high seroprevalence of helicobacter pylori antibodies in patients with hepatitis C virus. Since then, the relation between helicobacter species and liver disease in human was investigated. The aim of the present work was to identify and study the prevalence of some helicobacter species [helicobacter pylori [HP] and helicobacter pullorum] in HCV positive liver cirrhosis with and without hepatocellular carcinoma [HCC] in humans. The study was carried out on liver biopsies of 45 patients classified into 3 equal groups; Group I [control group]: where the liver biopsy specimens were taken from grossly normal areas of 15 hepatectomy specimens resected for hepatic benign tumours/cysts or metastatic tumours; Group II: 15 liver biopsy specimens from patients with HCV positive liver cirrhosis; and Group III which included 15 liver biopsy specimens belonging to HCV positive patients diagnosed by histopathology as hepatocellular carcinoma [HCC]. Identification of Helicobacter species as well as detection of Cag A positive and glm M positive strains was done in liver biopsies using polymerase chain reaction. Staining of helicobacter pylori in liver biopsies with immune stain was carried out. Helicobacter genus DNA was detected in 15 cases out of 45 studied cases: 6 cases out of 15 [40%] in group II [liver cirrhosis group], 8 cases out of 15[53. 33%] in group III [HCC group], and only one case out of 15 [6.67%] in the control group. The prevalence of helicobacter positive cases were significantly higher in group II [liver cirrhosis group] and in group III [HCC group] than in group I [control group] [P=0.02].No significant difference between the three studied groups was found regarding the Cag A and the glmM gene status. Helicobacter pullorum was detected in only two cases; one in group II and the other in group III. Helicobacter pylori was detected by immune stain in 4 cases out of 15 cases positive for HP by PCR in group III [HCC]. Helicobacter DNA is present in liver tissue of HCV positive liver disease. Further research is recommended to explore the role of Helicobacter species in the progression of HCV positive liver disease to HCC