الفهرس 
Virology, genotypes and structure of HCVOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) infection badly affects the liver and represents a critical health thread in Egypt. The parasitic diseases such as schistosomiasis, toxoplasmosis, or amebiasis were highly distributed among Egyptian citizens and affect the liver status in various ways. Co-infections of these parasites with HCV are possible and accompanied by negative clinical consequences. The current study shed the light on the prevalence of Toxoplasma gondii, Entamoeba histolytica, and Schistosoma infections among the HCV patients. Also, the current study was done to monitor the clinical, biochemical, and hematological changes in T. gondii, E. histolytica, and/or Schistosoma co-infection in the HCV-infected patients from Menoufia Province, Egypt.
In the present study one hundred and eighty patients chronically infected with HCV from private medical laboratories, Menoufia provinces, Egypt during the period between October 2017 and December 2018 were enrolled in the present study. The patients included seventy-five females and one–hundred and five males, with a mean age of (50.35±0.75) years. Out of one hundred and eighty examined HCV-positive patient’s samples, 109 blood samples were collected and examined, including HCV mono-infected patients, and co-infected with T. gondii, E. histolytica, and/or Schistosoma. To evaluate the clinical, hematological, and biochemical alternation, the study population was divided in to nine groups:
Group-I: Eighteen patients with chronic HCV mono- infection.
Group-II: Three patients with concomitant acutely infected T. gondii (IgM positive) and chronic HCV infections.
Group-III: Thirty- one patients with concomitant chronically infected T. gondii (IgG positive) and chronic HCV infections.
Group-IV: Six patients with concomitant E. histolytica (IgG positive and cyst detected) and chronic HCV infections.
Group-V: Seven patients with concomitant Schistosoma (Ig positive) and chronic HCV infections.
Group-VI: Six patients with concomitant T. gondii (IgG positive) plus E. histolytica (IgG positive) and chronic HCV infections.
Group-VII: Twenty-seven patients with concomitant T. gondii (IgG positive) plus Schistosoma (Ig positive) and chronic HCV infections.
Group-VIII: Seven patients with concomitant E. histolytica (IgG positive) plus Schistosoma (Ig positive) and chronic HCV infections.
Group- VIIII: Four patients with concomitant T. gondii (IgG positive) plus E. histolytica (IgG positive) plus Schistosoma (Ig positive) and chronic HCV infections.
Patients with HCV were examined for T. gondii, E. histolytica, and Schistosoma using ELISA or indirect haemagglutination test, and fecal examination was done to detect the E. histolytica cyst stage or Schistosoma ova, and some clinical parameters were demonstrated (compensated cirrhosis using Fibro-scanTM, complete blood count, fasting sugar, alpha-fetoprotein (AFP), thyroid-stimulating hormone (TSH), liver and kidney functions.
Overall prevalence of T. gondii IgG and IgM was 65% and 3.89%, respectively. Moreover, the prevalence of E. histolytica, and Schistosoma was (50% and 21.67) and (42.22% and 1.67%), using serological means and stool examination, respectively. Multiple parasitic infections (T. gondii and E. histolytica), (T. gondii and Schistosoma), (E. histolytica, and Schistosoma), and (T. gondii, E. histolytica, and Schistosoma) were 22.78%, 16.67%, 10.56%, and 10.56%, respectively, among HCV-infected patients. Significant differences were demonstrated in the prevalence of T. gondii, E.
histolytica, and Schistosoma among HCV patients based on age, gender, and residence.
Liver cirrhosis in patients with concomitant multiple parasites during chronic HCV infections showed a high percentage compared to HCV mono-infected patients. Moreover, significant increases in the level of AFP, AST, PT, and the relative monocyte counts were demonstrated in patients with concomitant multiple parasites during chronic HCV infections compared to HCV mono-infected patients. Changes in the levels of platelets and relative lymphocytes/neutrophils count were detected during dual or multiple infections.
In conclusions, T. gondii, E. histolytica, and Schistosoma mono- or multiple infections are highly existed among HCV patients from Menoufia Province, Egypt. Multiple parasitic infections represented serious risk factors for chronic HCV patients. It is recommended to screen these parasitic diseases among HCV patients to reduce the HCV clinical outcome.