1Maha I Shehata, 2Wafaa H Abbas Helmy, 3Gamal M Abou El-Naga and 4Mona Abdel Raouf Abdel Kader.
Departments of 1Microbiology, 2Phathology and 4Internal medicine, Faculty of Medicine, Al-Azhar University and 3Pathology Department, Ain Shams University, Cairo, Egypt.
Hepatitis C virus (HCV) and Schistosoma mansoni are major hepatotropic agents, that may lead to cirrhosis and eventually, hepatocellular carcinoma (HCC). Immunopathologic changes and early DNA alterations in the liver were studied on two groups of patients, all HCV-RNA PCR positive and HBs Ag were seronegative : group I; included 31 cases with chronic HCV infection. Group II; included 7 cases with combined HCV - S. mansoni infections. Liver sections from the two groups were subjected to immunoperoxidase staining using HLA-DR monoclonal antibody and; DNA analysis by CAS 200 Image Analysis System. In group I; fourteen cases (45%) were found to have high HLA-DR experssion score on the surface of macrophages and lymphocytes in the portal tract as well as kupffer cells in hepatic lobules. These cases exhibited low histologic activity index (HAI) characteristic of mild and moderate hepatitis. On the other hand, low HLA-DR expression score was found in 17 (55%) cases with high HAI, characteristic of severe hepatitis. Nuclear DNA analysis revealed increased S-phase of hepatocytes cycle in 7 (18%) cases. DNA content ranged from 43% to 78%, with aneuploid peaks in three cases having high HAI score. Group II; were found to have low HLA-DR expression score although they exhibited low HAI. It is concluded, that in chronic HCV infection and combined HCV - schistosoma infection; low HLA-DR expression could reflect impaired tissue immunocompetence and that persistent exposure to viral antigen could induce global cellular DNA alteration.