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Chronic liver disease and hepatitis C virus in Egyptian patients
O M El-Medany1, K S El-Din Abdel Wahab, E A Abu Shady
1Microbiology Department, Faculty of Medicine, Al-Azhar University, Egypt.
Insights
This study found high rates of anti-HCV and anti-GOR antibodies in Egyptian chronic liver disease (CLD) patients, suggesting autoimmune involvement. Saliva is not reliable for diagnosing HCV infection but may help evaluate CLD activity.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic liver disease (CLD) in Egypt is frequently associated with Hepatitis C Virus (HCV).
- The role of autoimmune processes and specific autoantibodies, such as anti-GOR, in HCV-related CLD requires further investigation.
- Co-infection with bilharzia may influence the immune response in CLD patients.
Purpose of the Study:
- To evaluate the prevalence of anti-HCV and anti-GOR antibodies in Egyptian patients with CLD.
- To investigate the presence of HCV and GOR antigens in liver biopsies.
- To assess the diagnostic utility of serum and saliva for HCV infection and related autoantibodies.
Main Methods:
- Serum, saliva, and liver biopsy samples were collected from 45 CLD patients and 44 non-liver disease (NLD) controls.
- Anti-HCV (IgG) and anti-GOR antibodies were detected using ELISA.
- HCV and GOR antigens were identified in liver biopsies via immunostaining and indirect immunoperoxidase staining.
Main Results:
- High seropositivity for anti-HCV (82.2% in serum, 37.7% in saliva) was observed in CLD patients.
- Anti-GOR antibodies were detected in 42.2% of CLD patient sera and 2.21% of saliva samples.
- HCV antigen was found in hepatocytes and extrahepatic cells, while GOR antigen was present in hepatocytes and other locations.
Conclusions:
- The study confirms high anti-HCV seropositivity in Egyptian CLD patients, indicating potential autoimmune processes.
- Anti-GOR antibodies are common in CLD patients and are secreted in saliva.
- Saliva is not a reliable substitute for serum in diagnosing HCV infection or related autoantibodies but may aid in CLD activity assessment.
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 chronic liver disease (CLD) patients are the subject of this study. The samples that were collected included serum, saliva and liver biopsy. For comparison, 44 serum, saliva and liver biopsies were also collected from non liver disease (NLD) patients undergoing surgery at the Gastroenterology Surgical Center, Mansoura University.
Results:
Screening of antihepatitis C (anti-HCV) with a second generation ELISA test showed that 37/45 (82.2%) sera and 17/45 (37.7%) saliva samples from CLD patients were positive for the presence of anti-HCV (IgG), while, anti-HCV (IgG) was detected among 32/44 (72.7%) sera and 6/44 (13.6%) saliva samples from NLD patients. HCV antigen was detected by immunostaining in the liver biopsy sections of 11/45 (24.4%) CLD and in 6/44 (13.6%) NLD patients. HCV antigen was detected in hepatocyte cytoplasm and nuclei, in some endothelial 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 tested by ELISA for the presence of anti-GOR to determine the prevalence of autoantibody 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-GOR 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 extrahepatic localization was also noticed. A correlation between the detection of anti-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 patients were positive for anti-HCV and for anti-GOR.
Conclusions:
The results of the present study confirm the published anti-HCV high seropositivity among Egyptian CLD patients and point to an autoimmune processes in CLD. The liver biopsy findings stress the presence of HCV antigen in extra hepatic cells as well as in hepatocytes in CLD. Our data confirm that anti-GOR is commonly present in sera from CLD patients and show that 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 for the evaluation of CLD activity, when repeated sampling is necessary.