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Objective: Hepatitis C virus (HCV) core antigen (Ag) quantification by enzyme-immunoassays has been proposed as an economic and simpler alternative to HCV RNA detection. The current study was undertaken to assess the significance of HCV core antigen assay for the diagnosis of chronic HCV infection and monitoring response to antiviral therapy in Egyptian patients., Patients and Methods: Sixty three HCV antibody positive patients and ten interferon-treated patients were included in the current study. The included patients were divided according to their viral load into four groups as follows; group I (n=10): HCV RNA loads ≤ 10000 IU/ml, group II (n=20): HCV RNA loads > 10000 ≤ 100000 IU/ml, group III (n=33): HCV RNA loads >100000 IU/ml and group IV (n=10): interferon-treated HCV patients with a negative HCV RNA.  Serum HCV core Ag and RNA loads were assayed and their correlations, including linear regression lines, were calculated., Results: HCV core Ag exhibited a non-significant (p > 0.05) difference between all the studied groups. Concerning, group I patients, HCV core Ag levels and HCV RNA loads were positively correlated, with a correlation coefficient of 0.73 (p < 0.05). Group II and III showed stronger correlations; the recorded values were 0.81 (p < 0.0001) and 0.94 (p < 0.0001) for group II and III, respectively., Conclusions: HCV core Ag test can be used as an alternative to HCV RNA tests to evaluate chronic infection when the HCV RNA test is unavailable, but is not reliable enough for treatment monitoring.

Hepatitis C is a major global health burden and Egypt has the highest prevalence of hepatitis C virus (HCV) worldwide. The current study was designed to evaluate the beneficial therapeutic effects of ethanolic extracts of Nigella sativa, Zingiber officinale and their mixture in Egyptian HCV patients. Sixty volunteer patients with proven HCV and fifteen age matched healthy subjects were included in this study. Exclusion criteria included patients on interferon alpha (IFN-α) therapy, infection with hepatitis B virus, drug-induced liver diseases, advanced cirrhosis, hepatocellular carcinoma (HCC) or other malignancies, blood picture abnormalities and major severe illness. Liver function enzymes, albumin, total bilirubin, prothrombin time and concentration, international normalized ratio, alpha fetoprotein and viral load were all assessed at baseline and at the end of the study. Ethanolic extracts of Nigella sativa and Zingiber officinale were prepared and formulated into gelatinous capsules, each containing 500 mg of Nigella sativa and/or Zingiber officinale. Clinical response and incidence of adverse drug reactions were assessed initially, periodically, and at the end of the study. Both extracts as well as their mixture significantly ameliorated the altered viral load, alpha fetoprotein, liver function parameters; with more potent effect for the combined therapy. In conclusion, administration of Nigella sativa and/or Zingiber officinale ethanolic extracts to HCV patients exhibited potential therapeutic benefits via decreasing viral load and alleviating the altered liver function, with more potent effect offered by the mixture.

Background/aims: The invasive liver biopsy is still considered the gold standard for assessing patients with chronic hepatitis C (CHC). Our aim was to determine the operating characteristics of a non-invasive index based on blood biomarkers for the prediction of cirrhosis in CHC patients., Methods: Hyaluronic acid level was determined by radioimmuno-assay and its degrading enzymes and degradation products were determined by standard techniques in 153 patients with CHC with and without liver cirrhosis. Statistical analyses were performed by logistic regression, and receiver-operating characteristic (ROC) curves., Results: The multivariate discriminant analysis (MDA) selected a function based on absolute values of five biochemical markers; Score=[1.63+Hyaluronic acid (microg/l)x0.001+N-acetyl-beta-d-glucosaminidase (micromol/ml/min)x0.02+glucuronic acid (microg/dl)x0.015+glucosamine (microg/dl)x0.006+AST/ALT ratiox0.04]. The selected MDA function correctly classified 96% of the cirrhotic patients at a discriminant cut-off score=2.5 (i.e. less than 2.5 indicated CHC without liver cirrhosis and greater than 2.5 indicated liver cirrhosis) with high degrees of sensitivity (95%) and specificity (97%). The positive predictive and negative predictive values were also high (95% and 97%, respectively)., Conclusion: A patient with CHC can be simply and efficiently classified into cirrhotic or non-cirrhotic liver diseased patient using his or her MDA score.