الفهرس 
Chronic cirrhosisOnly 14 pages are availabe for public view
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Abstract
In this study (40) patients with clinical im”d laboratory evidence of chronic HCV infection were
inchided. They were selected frmn a group of cases referred to Ain Shams University Hospital.
History was obtained from each subject clinical and ultrasonographic examinations were carried
out. Patients were assessed by laboratory investigations which included liver function tests,
serological analysis for hepatitis B and C viruses using 3rd generation EIA and nested RT-PCR.
Proctosigmodoscopy with examination of rectal biopsies for schistosoma ova. Liver biopsy was
done to only (31) from the 40 patients, as it was hazardous in the remaining 9 patients due to
tense ascites and/or high prothrombin time.
They were 26 (65%) males and 14 (35%) females. Their ages
ranged from 37 to 62 years.
History of schistosomiasis was reported in 22 (55%) of the patients. Another 20 age and sex
matched individuals, served as controls they were clinically serological and sonographically free.
Clinical assessment of patients about jaundice in (18) (45%) Abdominal examination revealed
enlarged liver in (18) (45%) of the patients and enlarged spleen in (24) (60%).
HBs Ag and anti HBc antibodies were not detected, while anti HCV antibodies and HCV - RNA were
detected in all patients.
This was further confirmed by ultrasonographic examination of the patients, it revealed
normal liver size in (7) (17,5) of the patients
enlarged liver (28) (70%) and shrunken liver in (5) (12,5%) thickened portal tracts were detected
in (20) 50% of the patients splenic size was nonnal in (15) (37,5%) of the patients and was
enlarged in (25) (62,5%).
Proctosigmodoscopy and rectal snip examination revealed dead schistosoma mansoni ova in (22) (55%)
of the biopsies.
Serum total bilirubin was raised in (18) (45%) serum, AIT was raised in (18) (45%) serum AST was
raised in 26 (65%) serum AIT was raised in (16) (40%).Albumin was decreased in 26 (65%) &
prothrombin time was elevated in 16 (40%).
Histopathological assessment of 3 I liver biopsy specimens showed chronic hepatitis C with various
grades of inflammation and stages of fibrosis. The grades of inflammation varied from grade I to
grade 3. (I 0) patients (32,2%) were detected with grade I inflammation, (8) (25,8%) with grade 2
inflammation, and (13) (41,9%) with grade 3 inflammation the stages of fibrosis varied from stage I
to stage 4. (2) patients (6,45%) were detected with stage I fibrosis, (I) (3,22%) will stage 2
fibrosis, (8) (25,8%) with stage 3 fibrosis , and (II) (35,48%) will stage 4 fibrosis. Schistosoma!
hepatic fibrosis was detected in (15) (48,3%) of the biopsy spectmens.
Active cirrhosis was detected in (13), (41,9%) ofthe specimens while established cirrhosis was
detected in (6) (19,35%) of the specimens.
The serum levels of soluble ICAM-I were measured in patients with HCV and uninfected controls.
slCAM-1 levels were significantly elevated (P <0.04) in HCV infected patients compared to
uninfected controls. Similarity, siCAM- I levels were significantly elevated (P=O,OOI) with high grades ofliver inflammation in all groups of patients
except those with established cirrhosis (P 0,497).
There was no significant changes between the levels of siCAM-1 levels in patients will chronic
hepatitis only and mixed HCV and schistosomiasis.
The significant correlation between serum levels of siCAM-1 and the grades of inflammation of the
liver was higher (P=O,OO I) than the significance of the correlation between serum levels of ALT
and the grades of inflammation (P=0,0214). P=0,04 in chronic hepatitis & chronic hepatitis with
active cirrhosis.