Chronic liver disease and hepatitis C virus in Egyptian patients

BACKGROUND/AIMS: This study was designed to evaluate anti-HCV and anti-GOR in chronic liver-disease (CLD) caused by HCV alone or with bilharzia. METHODOLOGY: The parameters of hepatitis C virus (HCV) infection among 45 c hronic liver disease (CLD) patients are the subject of this study. The samp les that were collected included serum, saliva and liver biopsy. For compar ison, 44 serum, saliva and liver biopsies were also collected from non live r disease (NLD) patients undergoing surgery at the Gastroenterology Surgica l Center, Mansoura University. RESULTS: Screening of antihepatitis C (anti-HCV) with a second generation E LISA test showed that 37/45 (82.2%) sera and 17/45 (37.7%) saliva samples f rom CLD patients were positive for the presence of anti-HCV (IgG), while, a nti-HCV (IgG) was detected among 32/44 (12.7%) sera and 6/44 (13.6%) saliva samples from NLD patients. HCV antigen was detected by immunostaining in t he liver biopsy sections of 11/45 (24.4%) CLD and in 6/44 (13.6%) NLD patie nts. HCV antigen was detected in hepatocyte cytoplasm and nuclei, in some e ndothelial cells lining the hepatic cell cords, and in some bile duct cells . The serum and saliva samples from both CLD and NLD patients were also tes ted by ELISA for the presence of anti-GOR to determine the prevalence of au toantibody in HCV infected and non-infected patients. Anti-GOR was detected in 19/45 (42.2%) sera and in 1/45 (2.21%) saliva samples from CLD patients , while in the case of NLD patients, anti-COP antibodies were found in 7/44 (15.9%) sera and in 4/44 (9%) saliva samples. GOR antigen was detected by an indirect immunoperoxidase stain of liver biopsies. Positive GOR antigen signals were found in hepatocytes but granular cytoplasmic, and extrahepati c localization was also noticed. A correlation between the detection of ant i-GOR and anti-HCV revealed that, out of 37 anti-HCV positive CLD patients, there were 19 (51.3%) positive for anti-GOR, while 7/32 (21.8%) NLD patien ts were positive for anti-HCV and for anti-GOR. CONCLUSIONS: The results of the present study confirm the published anti-HC V high seropositivity among Egyptian CLD patients and point to an autoimmun e processes in CLD. The liver biopsy findings stress the presence of HCV an tigen in extra hepatic cells as well as in hepatocytes in CLD. Our data con firm that anti-COP is commonly present in sera from CLD patients and show t hat anti-GOR are secreted in saliva. Our results showed that saliva can not be used reliably, instead of serum, for the diagnosis of HCV infection or auto-antibodies related to HCV infection, but can be used as a parameter fo r the evaluation of CLD activity, when repeated sampling is necessary.