الفهرس 
Chronic Hepatitis COnly 14 pages are availabe for public view
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Abstract
Background: Chronic hepatitis C virus (HCV) infection is a major public health problem with over 170 million people infected worldwide. Chronic hepatitis C is associated with a wide spectrum of liver histological lesions ranging from mild chronic hepatitis to cirrhosis and hepatocellular carcinoma. In the past few years the emergence of novel and diverse helicobacter species associated with the pathogenesis of human enterohepatic diseases has been observed. The discovery of the presence of Helicobacter species DNA in liver material from patients with liver disease has led to the challenging hypothesis that these bacteria may play a role in evolution of hepatic lesions from chronic viral hepatitis to cirrhosis and HCC. Aim of the work: Our aim of this study is to detect the association between the presence of helicobacter pylori DNA in the liver and liver pathology and the possible role of this bacteria in the progression of HCV-related liver disease. Method: The study was carried out on 74 patients. The patients were classified into: Group I: Control (chronic HCV infection without histological activity F0 & A0). Group II: Chronic hepatitis C. Group III: HCV-related cirrhosis. Group IV: HCV-related cirrhosis with HCC. All patients and the control were subjected to: (1) Careful history taking and clinical examination. (2) Investigations: Liver function tests, Prothrombin time, CBC, Serum creatinine, Viral markers (anti-HCV, HBsAg), Quantitative HCV PCR, Serum alpha fetoprotein, Serum anti-H. pylori (IgG) antibodies, Urine & stool analysis, Chest x-ray, Abdominal ultrasound (US) & abdominal computed tomography (CT), Upper GIT endoscopy, Liver biopsy for (pathology & PCR for H. pylori). Results: There is significant difference in H. pylori IgG and H. pylori PCR (CagA gene) between studied groups, high positive cases in group IV( cirrhosis with HCC). There is no significant difference between H. pylori PCR (CagA gene) positive and negative patients as regard child classification, quantitative HCV PCR, WBCs, Hb, aminotransferase (ALT & AST) and serum bilirubin. There is significant difference between H. pylori PCR (CagA gene) positive and negative patients as regard peptic ulcer, serum albumin, INR and platelet count. There is significant correlation between H. pylori PCR positivity and Metavir score system (inflammation and fibrosis). Conclusions: A high prevalence of H. pylori DNA in the cirrhotic stage of chronic hepatitis C and in a large majority of HCC patients indicate that there is an association between the presence of H. pylori DNA in the liver and hepatitis C cirrhosis with or without HCC and suggests that these potentially carcinogenetic bacteria may be implicated in the progression of HCV-related liver disease. Our finding still speculative. More studies are therefore needed to confirm whether a causal association exist between the presence of Helicobacter spp in the liver and the development of cirrhosis and hepatocellular carcinoma. Our observation grows in importance when it is considered that Helicobacter infections can be eliminated by simple antibiotic treatment as this might affect disease progression of a chronically HCV infected patients.