الفهرس 
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Abstract
Liver disease is widely distributed in Egypt and is becoming an ever increasing burden on our economy and health care system. Schistosomiasis is a common parasitic disease. Schistosomiasis is largely an infection found in rural areas, the highest reported prevalence in Egypt is 22%. Infection with the hepatitis C virus (HCV) is one of the leading causes of progressive liver disease. Studies of the epidemiology of Schistosoma and HCV infections have indicated that the Nile Delta region of Egypt has among the highest prevalence rates of Schistosoma (22%) and HCV in Egypt (10-20% of the population). . Aims: The Study was carried out on the area of Kafr El-Ghab _Markaz Kafr Sad_Damietta governorate as a particular area of north Delta in Egypt, to represent the cultivated medium at Damietta. This Study was designed to provide the epidemiological and physiological features which illustrate the correlation between liver disease resulting from Schistosoma and HCV. Study cases: between the beginning of February 2012 and the end of January 2013, all prospective or consecutive patients with chronic liver diseases tested HCV- RNA quantitative PCR and positive anti-HCV antibody (HCV carriers) with some of them having Schistosomiasis (Detection of Bilharzial antibodies by Indirect haem-agglutination Assay (IHA)), whom were admitted to El.Safwa lab., Kafr El-Ghab, Markaz Kafr Sad, Damietta, Egypt. A group of 12 normal healthy adults were carefully selected as non infected cases (control group). . Methods: Each one the patients or a non infected case was reviewed for epidemiological data, including age, sex, occupation, medical history and others. Tests were conducted for serum HCV antibodies for every person. HCV- RNA quantitative by PCR carried out on two groups (HCV group and HCV and schistosoma group). Detection of Bilharzial Antibodies in human serum for schistosoma group and HCV carriers & infected with schistosoma group. The panel of liver function tests was conducted including determination of serum levels of (GGT), aminotransferases (such as (ALT) and (AST)), ALP, bilirubin, albumin, total Protein and AFP as tumor marker. The hematological parameters were assessed including Hb content, RBCs count, WBCs count, Platelets count, Prothrombin time. Oxidative stress biomarkers including Catalase enzyme, Nitric oxide, SOD and GPX. RESULRS: Levels of GGT(0.002) ALT(<0.001) AST(0.008) were significantly higher in different patient groups than control. Bilirubin (0.02) and AFP (0.009) were significantly higher in HCV and Schistosoma infected group. Catalase(<0.001),GPx (<0.001), SOD(<0.001) and NO (0.002) were significantly higher in HCV& schistosoma infected groups. CONCLUSIONS: Based on the present study, the main biochemical responses in different stages of liver disease in HCV carriers and patients infected with schistosoma can be summarized as (1)- Elevated serum GGT indicates liver damage (especially biliary function), cholestasis. and diabetes. (2)-Whereas elevated serum ALT is associated to the primary and progressed stages, elevated AST is linked to the progressive stage of the disease. (3)- Lowered levels of serum albumin are closely linked to the progressive stages (cirrhosis) of the disease. (4) Elevated levels of bilirubin are likely related to cirrhosis and hepatocellular carcinoma. (5)- Elevated levels of oxidative stress biomarkers(Catalase enzyme, Nitric oxide, Superoxide Dismutase and Glutathione Peroxidase) are likely related to hepatitis , cirrhotic and hepatocellular carcinoma stages. (6)- Decreased hematological parameters including haemoglobin contents, Red blood corpuscles (RBCs), White blood cells (WBCs) and platelets. Elevated Bilharzial antibodies.