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In tile present study the clinicopathological aspects of H. pylori infection in different parts of the stomach were investigated in 36 patients. The results showed that 28 patients (77.8%) were H. pylori positive and 8 patients (22.2%) were H. pylori negative by histopathology and confirmation with modified Giemsa stain. There was no statistically significant difference belween H. pylori positive and negative patients regarding dyspeptic symptoms or intestinal metaplasia histopathologically. Histopathological examination revealed chronic gastritis with mononuclear cell infiltration in all studied patients. According to the degree of cell infiltration, chronic gastritis was graded as mild, moderate and severe. There was a statistically significant difference between H. pylori positive and H. pylori negative patients regarding both severity and activity of chronic gastritis in the antrum and body compared to the fundus. Also, there was significant correlation between the grade of H. pylori colonization and the grade of chronic active gastritis on one hand and between H. pylori infection and atrophic gastritis. The serum anti-H. Pylori - IgG positive cases who were H pylori negative by history, showed atrophic gastritis acid intestinal metaplasia. This may be due to the fact that the mucosa has become inhospitable for H. pylori.

The objectives of this study were to define the prevalence of intrafamilial transmission of HCV and evaluate the risk factors in this setting. A cross-sectional, family-based seroepidemiological study was performed in Cairo Liver Center and Oncology Diagnostic Unit, Ain Shams University. A total of 102 index patients (72 males and 30 females) with type C chronic liver disease and their 305 family contacts were studied. Only 265 family contacts were eligible for the study as they showed no previous history of exposure to risk factors. Overall, 15 family contacts (5.7%) were positive for anti-HCV, indicating a lower anti-HCV prevalence among family contacts than the general population in Egypt. Spouses were at higher risk of infection (16.7%) than family members (2.6%). Among the repeatedly positive samples for anti-HCV, only 3 samples were HCV-RNA positive (1.1%), all were spouses. Logistic regression analysis revealed that spouses reporting promiscuous sexual relations were at higher risk than those with normal sexual relations. Contacts sharing personal objects were also at higher risk to develop HCV infection. Index cases reporting previous blood transfusion (18.6%), i.v. antibilharzial therapy (33.3%), multiple sex partners (1.0%) or advanced liver diseases were more infective to their family contacts. The contacts of index cases had increasing risk of HCV infection with increase in age and duration of contact. The prevalence rate of intrafamilial spread of HCV infection is low compared to the rate among general population, emphasizing its limited role in transmitting HCV infection. Long duration of sexual contact and promiscuous sexual activities were major risk factors in this setting.

In a randomized controlled trial, sixty chronic hepatitis B liver disease patients (HBsAg +ve and HBV-DNA +ve) were randomly allocated into 2 groups. The first group comprised of 30 patients who were subdivided into 2 subgroups according to the HBeAg/anti-HBe system. One subgroup was HBeAg-positive (12 patients) and the other was anti-HBe-positive (18 patients). All were given human lymphoblastoid IFN alpha (Wellferon-R) at a dosage of 5 MU, thrice weekly for 4 months. The other 30 patients served as a control group, six of whom were lost during the study. The initial response was loss of HBV-DNA in 66.6% of the HBeAg +ve subgroup (8/12 patients), 33% in the anti-HBe subgroup (6/18 patients) and in 8% in the control group (2/24 patients). Patients and controls were followed up for 8 months after the end of IFN therapy. A sustained response (loss of HBV-DNA) 8 months after discontinuation of IFN was attained in 5/12 patients (41.6%) of the HBeAg-positive subgroup compared to none (0/24) in the control group (p < 0.05). In the anti-HBe subgroup, a sustained response in 2/18 patients (11%) compared to none (0/24) in the controls was not significant. We conclude from this study that (Wellferon-R) at a dosage of 5 MU given thrice weekly for 4 months was significantly better (p < 0.05) than no treatment in producing a sustained response among the HBeAg +ve subgroup of patients. On the other hand, in the anti-HBe subgroup the outcome of the previous schedule was not significantly better than in controls due to the small numbers involved although 2 patients did have a sustained response.

Unlabelled: Ninety-four HCV-positive CLD cases (56 males and 38 females with a mean age of 36 years) were matched to 50 HCV-ve CLD patients as a control group (30 males and 20 females with a mean age of 43 years). HCV antibody was screened by second generation ELISA, Ortho.. Autoantibodies (SMA, ANA, AMA, LKM1, SMA-anti-actin) were screened by immunofluorescence on cryostat murine sections using 1:40 serum dilution. Screening showed that 40 of 94 42.5%) HCV-positive CLD patients were positive for autoantibodies. Thirty eight of these were +ve for smooth muscle antibody (SMA) (40.4%), but all of them were negative for anti-actin, 3 were +ve for antinuclear antibody (ANA) (3.19%), while another 2 were +ve for antimitochondrial antibody (AMA) (2.1%). In the control group, 8(16%) were autoantibody +ve, 6 (12%) were SMA +ve, 2 (4%) were ANA +ve, 1 (2%) was AMA +ve and non had LKM1-Ab. There was significant difference between cases and controls concerning the autoantibody prevalence (P < 0.05). Although the prevalence of SMA among HCV +ve CLD cases was high (40%), yet, anti-actin antibody was totally negative, disclosing the insignificance of SMA positivity. It has been reported that the relevant SMA-AIH-1 is directed to the cell actin, whereas other SMAs have nothing to do with the immuno-pathogenesis of AIH., Conclusion: It seems that the predominant HCV genotype in Egypt is hardly associated with autoimmune phenomena.

Unlabelled: In this trial, we have checked 50 anti-HCV positive, HCV-RNA PCR positive chronic liver disease cases, 44 males, 6 females with a mean age of 51 years. HCV-RNA extraction and genotyping was carried out at the Department of Medical Microbiology, University of Edinburgh, U.K. results showed that 47 (94%) of patients were of genotype 4 and 3 (6%) were of genotype 1. Liver biopsies were performed in 22 only out of the 50 patients studied. The 3 genotype 1 patients were biopsied, 2 had cirrhotic profile and one had CAH. Of 47 genotype 4 patients, 19 were biopsied, 3 were CPH, 2 had CLH, 9 had CAH, 4 had cirrhosis and one patient had HCC., Conclusion: It appears that Egypt hosts predominantly HCV genotype 4 and less commonly genotype 1. This finding might have important implications concerning the epidemiological aspects, pathogenesis and response to antiviral therapy.