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Abstract
: Prevalence of HCY infection varies throughout the world with the
highest number of infection reported in Egypt. The risk factors for HCY transmission that specifically sets Egypt a part from other countries is history of parenteral antischistosomal therapy. Other routes of transmission and risk factors include intravenous drug users and blood transfusion. HCY has hepatic manifestations including acute hepatitis, chronic hepatitis, fulminant hepatitis, liver cirrhosis and
hepatocellular carcinoma. There are several extrahepatic manifestations of HCY as hemolytic anemia, thrombocytopenia, thyroid disease, peripheral neuropathy. lymphoma, polyartritis nodosa and dermatological diseases. Kidney disease associated with HCY infection including membranopliferative glomerulonephritis and membranous nephropathy. Focal segmental glomulosclerosis and IgA nephropathy. Cryoglobulinemia types II and III and diabetes mellitus are common in renal transplant patients. HCY infection is the main cause of chronic liver disease after renal transplantation. It is considered to be a risk factor for graft loss and patient death. In dialysis patients with chronic HCY infection, serum aminotransferase levels are not reliable in determining disease activity and fibrosis severity. Liver biopsy remains the gold standard for assessment of disease severity. Because of the current shortage of cadaveric kidneys, grafting kidneys from anti-HCY positive donors into anti-HCY positive recipients. Transplantation of kidneys from anti-HCY positive donors only into HCY RNA viremic patients may be a new option. It is important to kidney transplant patients to be examined before transplantation not only to diagnose the infection but also to identify patients whom became clinically free. Kidney transplant patients who are positive for HCY antibodies (anti-HCY) have higher rates
of liver complications and lower survival rates after transplantation than anti-HCY negative patients. eradication of HCY infection before transplantation seems to reduce
the risk for HCY -associated renal dysfunction after transplantation and may reduce the risk of HCY progression. Standard treatment of HCY in dialysis patients is IF monotherapy as thrice weekly administration of non-pegylated-Il-Nj-, was more efficacious and associated with a shorter duration of treatment-related adverse effects
than once-weekly administration of pegylated IFN.