RESUMO
Thirty patients with bilharzial liver fibrosis, splenomegaly and hepatocellular failure [jaundice, ascites, gynecomastia, spider nevi] were studied. Colonic swab showed Bilharzia ova and colonic bilharziasis in all of them. Upper endoscopy showed esophageal varices in 22 cases. Disturbed biochemical liver functions were present in all cases. 16 patients [53.3%] had positive anti-HCV antibodies by second generation ELISA test and 6 patients [20%] had positive HBsAg. Three cases had both anti-HCV and HVsAg. All cases were negative for antinuclear and antismooth muscle antibodies. Liver biopsy showed histological changes of cirrhosis in 20 cases [66.7%] and chronic active, chronic lobular hepatitis in the remaining cases. Bilharzial pigment and/or Schistosoma ova, granuloma were presented in all cases. 8 cases [16.7%] showed ground glass appearance with positive orcein stain characteristics of HBsAg. In conclusion, the presence of positive markers of HCV in patients with hepatic schistosomiasis may contribute to liver cell failure. However, it may reflect only a chronic carrier state of anti-HCV, in such cases liver biopsy can differentiate by the presence of histopathological changes characteristic of chronic hepatitis C