Title: Noninvasive Markers for the Assessment of Liver Fibrosis and Cirrhosis in Egyptian Patients with Chronic Hepatitis C and Schistosomiasis Coinfection
Authors: Hadeer A Abbassy, Amany A Elbanna
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.75
Abstract
To assess the role of noninvasive biomarkers in patients with chronic hepatitis C virus (HCV) and schistosomiasis coinfection and to correlate them with hepatic fibrosis and activity.
This study was carried out on one hundred HCV positive Egyptian patients with detectable serum HCV RNA. All patients were positive for anti-schistosomal antibodies prior to HCV treatment. Serum cryoglobulins, serum autoantibodies; ANCA, AMA, ASMA and expression of CD 25 on CD4+ T cells were measured. APRI score, Fibrotest and Actitest scoring systems using computed algorithm were done to assess the degree of liver fibrosis.
A high prevalence of cryoglobulins and autoantibodies was detected. There was a statistical difference between cryopositivity and the degree of liver fibrosis and cirrhosis. Autoantibody positive patients were found to have a significantly higher Fibrotest and Actitest score as well as APRI score than autoantibody negative patients. There was a significant reduction in CD4+ T cells % while CD4+25+ T cells % were significantly higher in HCV patients than controls.
Serum cryoglobulins and autoantibodies were related to the degree of liver fibrosis and cirrhosis based upon Fibrotest and Actitest and thus may serve as non invasive indices for assessment of hepatic fibrosis. There was a significant up-regulation in CD4+ CD25+ T cells but no correlation was found between APRI score and CD4+T cell % or CD4+25+T cell %. Thus CD25 expression can only be considered as a critical marker for evaluating the immune regulation in patients with coinfection of HCV and schistosomiasis but not as a marker to measure the degree of liver fibrosis and necro inflammatory activity in these diseases.
Keywords- Noninvasive; markers; liver; fibrosis; HCV; schistosomiasis; coinfection.
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