Background By 27 June 2020, almost half a million people had died due to COVID-19 infections. The susceptibility and severity of infection vary significantly across nations. The contribution of chronic viral and parasitic infections to immune homeostasis remains a concern. By investigating the role of interferon (IFN)-γ, we conducted this study to understand the connection between the decrease in numbers and severity of COVID-19 cases within parasitic endemic regions. Our research included 375 patients referred to hospitals for diagnosis of COVID-19 infection. Patients were subjected to full investigations, in particular severe acute respiratory syndrome coronavirus-2 nucleic acid and Toxoplasma IgM and IgG antibody detection, stool examination, and quantitative IFN-γ measurement. Results The majority of the studied cases had chest manifestation either alone (54.7%) or in association with gastrointestinal (GIT) manifestations (19.7%), whereas 25.6% had GIT symptoms. We reported parasitic infections in 72.8% of mild COVID-19 cases and 20.7% of severe cases. Toxoplasma gondii, Cryptosporidium, Blastocyst, and Giardia were the most common parasitic infections among the COVID-19 cases studied. Conclusion The remarkable adaptation of human immune response to COVID-19 infection by parasitic infections with high levels of IFN-γ was observed in moderate cases compared with low levels in extreme cases. The potential therapeutic efforts aimed at the role of parasitic infection in immune system modulation are needed if this hypothesis is confirmed.

BackgroundChronic HCV infection combined with occult hepatitis B infection has been associated with liver enzymes flare, advanced hepatic fibrosis and cirrhosis, poor response to standard interferon-α, and increased risk of HCC. This study aimed to elucidate the prevalence of occult hepatitis B infection in Egyptian chronic HCV patients, and to clarify its role in non-response of those patients to pegylated interferon/ribavirin therapy. This study enrolled 155 consecutive chronic HCV patients under pegylated interferon/ribavirin therapy. All patients were exposed to clinical assessment, biochemical, histological and virological examinations. HBV parameters (HBV DNA, anti-HBc, anti-HBs) and patients' response status to the combination therapy were determined.ResultsIn this study, occult hepatitis B infection occurs in 3.9% of Egyptian chronic HCV patients; tends to affect younger age patients, associated with higher base line HCV viral load, less hepatic fibrosis than monoinfected patients. This occult hepatitis B infection is not a statistically significant cause of non-response to pegylated interferon/ribavirin therapy. Anti-HBs was not associated with any biochemical, histological or virological abnormalities in those patients, contrary to low response rate to therapy and higher HCV viral load that was observed with anti-HBc.ConclusionsDetection of HBV DNA in HBsAg negative chronic HCV patients plays a non significant role in non-response of Egyptian patients to pegylated interferon/ribavirin therapy.

Aim of the study: Liver cirrhosis is an irreversible destructive liver disease that is associated with a wide range of complications. Among the recognized comorbidities of liver cirrhosis are sleep-disordered breathing (SDB), which is being more and more often described among cirrhotics. This study aimed to detect the prevalence of SDB among Egyptian post-viral cirrhotic adults. Material and methods: This study enrolled 48 post-viral cirrhotic patients and 16 apparently healthy control subjects. All patients and controls were evaluated by thorough history taking, full clinical examination, laboratory investigations, the Epworth Sleepiness Scale questionnaire, the Berlin Questionnaire and polysomnography. Results: Patients and controls were comparable as regards baseline demographics. Patients with liver cirrhosis had higher frequency of SDB compared to controls (56.2% vs. 12.5%, p = 0.002). The most frequently encountered SBD patterns among cirrhotics were obstructive sleep apnea and apnea hypopnea index. Moreover, SDB was more severe among cirrhotics (25% were mild, 16.6% were moderate and 14.6% were severe obstructive sleep apnea-OSA) compared to the healthy controls (all were mild). Conclusions: It seems that post-viral cirrhotic patients had a wide range of SDB with variable degrees of severity compared to the healthy controls.

Conclusion: Tuberculosis, typhoid fever, and brucellosis signified the major identified infectious causes for FUO in Port Said governorate/Egypt. Toxoplasmosis can be represented as one of FUO infectious causes. Patients with toxoplasmosis either presented with lymphadenopathy or not, all of them had hepatosplenomegaly, high CRP, leucocytosis, and eosinophilia.

Background and study aim: Hepatitis C is the most pressing public health challenge in Egypt with variable prevalence rates among different age groups. This study aimed to detect the efficacy and adverse effects of sofosbuvir plus daclatasvir therapy in treatment of chronic HCV patients in Sharkia governorate. Patients and Methods: One hundred and ten patients were included in this study, divided into 4 groups; group I: 55 treatment naïve patients receiving (sofosbuvir + daclatasvir) for 12 weeks, group II: 36 treatment naïve patients receiving (sofosbuvir + daclatasvir +ribavirin) for 12 weeks, Group III: 9 treatment experienced patients receiving (sofosbuvir + daclatasvir + ribavirin) for 24 weeks and Group IV: 10 chronic HCV patients not receiving anti-viral therapy. Patients were followed by clinical and laboratory evaluation monthly during treatment and for 3 months after end of treatment. In addition, the virological response and adverse effects were reported. Results: The rate of SVR response was equal in the three treated groups. There was statistically significant increase in nausea and headache in groups I and II while arthralgia, myalgia and fatigue were more frequent in group I. There was also statistically significant improvement in Child score among treated cirrhotic patients after treatment. Conclusion: Daclatasvir plus sofosbuvir with or without ribavirin for 12 or 24 weeks is highly effective in treatment of naïve or experienced Egyptian HCV patients in Sharkia governorate. This combination is well tolerated in both cirrhotic and noncirrhotic patients with mild adverse effects.