clinical picture of hepatitis C virus as a concomitant infection with fascioliasis

Hepatitis C and human fascioliasis are two of the most important public health problems locally and internationally. Each one has its own complications regarding spreading to man, clinical picture, laboratory and serologic diagnosis, treatment and prevention. Concomitant human infection with both magnified the complications. Clinically, both diseases [HCV and fascioliasis] have their own broad signs and symptoms. In concomitant infection, the clinical pictures of both showed some variations. The most common feature in fascioliasis and HCV patients was easy fatigability in 78.6% and the lowest was 7.18% for each of tympanic abdomen, tender colon, tender right upper quadrant, itching, arthritis, epi-gastric pain, and right quadrant pain. The eosinophilia% ranged from 5-24 and the haemogiobin ranged from 7-11.1 gm/dl. In patients with fascioliasis alone, the most come feature was pallor in 96.15% and the lowest was 3.85% for each of splenomegaly, ascites and itching. Eosinophilia% ranged from 1 to 22 and haemoglobin ranged from 6-12 gm/dl. In general, the double infection with both HCV and fascioliasis magnified the laboratory and clinical pictures of such patients

liver profile in patients with hepatitis C virus and/or fascioliasis

In this study, twenty HCV/PCR-RNA positive patients with neither infection nor infestation were 15 males and five females with ages ranging between 17-78 years old. Liver function tests: S. albumin was decreased in 15 patients [75%], total protein decreased in 3 patients [15%], total bilirubin increased in 7 patients [35%], AST/ALT increased in 3 patients [15%]. Globulin value increased in 15 patients [75%]. A/G ratio decreased in 12 [60%]. Ten normal individuals [five males and five females], gave normal findings. However, a 19 years-old female had non significant elevation [0.26mg/dl] in direct bilirubin. Liver function tests: one patient had increased AST/ALT, Globulin value decreased [-0.2] in another one [10%] and A/G ratio increased [+0.3 to+0.6] in three [30%] individuals. Twenty randomly selected patients [15 males and five females] HCV/3 rd generation ELISA showed ALT elevation in 17 [85%], AST in all [100%], S. albumin decreased in 9 [45%], and increased in 1 [5%]. Total protein decreased in 3 [15%], total bilirubin increased in 7 [35%] and direct bilirubin in 4 [20%], AST/ALT value increased in 3 patients [15%], Globulin value increased in 15 patients [75%]. A/G ratio decreased in 12 [60%]. Three patients had schistosomiasis, one 30 years old male had increased AST/ALT, normal globulin, increased A/G and positive HBs-Ag. The second one was a 33 years old male had normal AST/ALT, normal globulin, increased A/G and positive HBs-Ag. The third patient was a 19 years old female with normal AST/ALT and normal globulin, increased A/G and positive HBs-Ag. Two patients had fascioliasis, one was a 20 years old male with increased AST/ALT, globulin normal, A/G normal and negative HBs-Ag. The second one was a 26 years old female with normal AST/ALT and normal globulin, increased A/G and positive HBs-Ag. The other four positive HBs-Ag patients were parasite-free. Also, the other HCV/ELISA positive were negative for HBs-Ag. HCV/ELISA may have cross-reacted with HBs-Ag and/or with elevated ALT and gave false positive HCV. The 3rd generation ELISA in detection of HCV was not as sensitive as PCR/RNA. Out of 41 fascioliasis patients [26 males and 15 females], 14 were positive HCV/ELISA [34.1%], but only six were positive HCV/PCR [14.6%]. ALT increased in 18 fascioliasis patients [43.9%], AST in 23 patients [56.1%] but, albumin decreased in 7 patients [17.1%], total protein decreased in 5 [12.2%], but total bilirubin increased in 14 [34.1%] and direct bilirubin increased in 2 [4.9%]. Liver function tests of 14 fascioliasis and ELISA positive HCV showed AST/ALT increased in 6 [42.9%], globulin increased in 3 [21.4%] and decreased in 6 [42.8%]. A/G decreased in 4 [28.6%] and increased in 8 [57.2%]. Liver function tests of pure 27 fascioliasis patients showed that AST/ALT increased in 8 [29.6%], globulin increased in one patient [3.7%] but decreased in 10 [37.0%] and A/G ratio increased in 13 [48.1%]

HCV/PCR positivity in bile and doudenal aspiration of Fascioliasis and/or HCV patients

In this study, three bile aspirates taken from 10 fascioliasis patients [30.0%] showed HCV positivity by PCR/RNA. Also, four duodenal aspirates [66.7%] taken from six HCV/PCR RNA positive patients and three duodenal aspirates [20%] taken from 15 pure fascioliasis patients showed HCV positivity by PCR/RNA This is the first time to demonstrate HCV/PCR-RNA in the bile and duodenal aspirates of fascioliasis patients and in the duodenal aspirates of HCV patients. So, PCR can be used for the detection of HCV in the bile and/or duodenal aspirates of HCV suspected patient. On the hand, this outcome results may incriminate HCV infection as concomitant with fascioliasis or incriminate fascioliasis as paving the way to HCV.

liver function profile in PCR-RNA Egyptian HCV-patients and normal controls

No doubt. Hepatitis C virus [HCV] is a real health problem worldwide. The liver function tests [S.ALT, S.AST, Albumin, Total Protein, Total Bilirubin and Direct Bilirubin] were evaluated in 20 PCR-RNA positive HCV-patients and 10 cross matched apparently healthy population. All the HCV-patients and controls were free from liver helminthes. The results showed that in the HCV-patients, there was elevation in the level of S.ALT [17/20 or 85%], S.AST [20/20 or 100%], Total Bilirubin [7/20 or 35%], and [4/20 or 20%]. Besides, there was neither a correlation between sexes nor the degrees of viraemia and the elevation of these four parameters. However, serum levels of Albumin, and Total Protein were within the normal range. On the other hand, in the controls the levels of the six tests were within the normal range. Nevertheless, only one control subject who had positive HBs-Ag, showed elevated Total Bilirulin and Direct Bilirubin. Consequently, these tests are indicative as useful and dependable markers in the noninvasive diagnosis of the hepatitis C virus [HCV]

Plasma fibronectin and serum complement c3 levels in chronic active hepatitis following virus B versus virus C infection

Plasma fibronectin and serum complement C3 levels were estimated in 30 patients with chronic active hepatitis [CAH] post virus B and another 30 patients with CAH post virus C as well as 20 normal healthy subjects. Fibronectin level was significantly increased in CAH when compared to normal controls. Moreover, fibronectin level was significantly increased in CAH following virus C when compared to CAH following virus B hepatitis. Concerning complement C3 there was no significant changes in the different groups studied. It is concluded that CHA following virus C may lead to vigorous inflammatory damage than CAH following virus B infection

case of oriental diagnosis as pseudolymphoma cutis

A parasitologically positive case of oriental sore was diagnosed pathologically as pseudolymphoma cutis. The case was successfully treated with Astiban