Assessment of human cytomegalovirus co-infection in Egyptian chronic HCV patients

Abstract

Human cytomegalovirus (HCMV) is the most common cause of severe morbidity and mortality in immune- compromised individuals. This study was conducted to determine the incidence of HCMV infection in HCV patients who either spontaneously cleared the virus or progressed to chronic HCV infection. The study included a total of eighty four cases (48 females and 36 males) that were referred to blood banks for blood donation with an age range of 18-64 years (mean age 37.62 ± 10.03 years). Hepatitis C virus RNA and HCMV DNA were detected in sera by RT-nested PCR and nested PCR respectively in all subjects. Immunoglobulin G levels for HCV and HCMV were determined. Besides, IgM antibodies for HCMV infection were also determined in subjects' sera. Fifty three out of 84 cases (63%) were positive for HCV-RNA while 31 (37%) cases had negative HCV RNA. Forty six (87%) and 13 (25%) cases out of 53 HCV RNA positive patients were positive for HCMV IgG and IgM antibodies respectively. While 20 of 53 cases (38%) had detectable HCMV DNA. To examine the role of HCMV infection in HCV spontaneous resolution, two groups of HCV patients, group 1) chronic HCV infection (positive HCV RNA and positive IgG antibodies) vs group 2) spontaneous resolution (negative HCV RNA and positive IgG antibodies) were compared. The percentages of positive CMV IgG and IgM results is higher in chronic HCV patient than those in spontaneously cleared HCV patients and the difference is highly statistically significant (P value < 0.001). Also, there is a general trend towards elevated levels of CMV IgG antibodies in HCV chronic patients than those in spontaneously cleared HCV patients (P value < 0.02). HCMV DNA detection in group 1 was more than twice the value observed in group 2 (38% vs 14.3%, P value < 0.001). Moreover, levels of liver enzymes were significantly higher in HCV RNA positive cases co-infected with HCMV DNA than HCMV negative cases (P value < 0.001). The results indicate the role of HCMV in the liver pathogenesis. We conclude that chronic HCV patients co-infected with HCMV infection can be regarded as high risk groups for liver disease progression where they should be monitored for the long term outcome of the disease.

Evaluation of serum endoglin as noninvasive marker in hepatocellular carcinoma

“…HCV is responsible for infecting over 20 million in Arab countries (3). The prevalence of that virus is reported to be higher in Egypt than in any other Arab country; the prevalence of HCV among the general populations is variable from 13 to 22% [4]. It is found to be 14.5% among blood donors, 7.7% among healthcare workers, and 47.2% in chronic liver disease patients [5].…”

Hepatitis C Viremia Is Associated with Cytomegalovirus IgG Antibody Levels in HIV-Infected Women

“…We are aware of only one small study that examined the association of HCV infection with measures of the immune response against CMV [16]. The results of that study showed that both CMV seroprevalence and CMV IgG levels differed by HCV infection status [16]. An important limitation of that study, though, aside from its small sample size was that age and other potentially confounding factors were not accounted for in the analysis.…”

“…We are aware of only one small study that examined the association of HCV infection with measures of the immune response against CMV [16]. The results of that study showed that both CMV seroprevalence and CMV IgG levels differed by HCV infection status [16].…”

Assessment of Cox2 and CMV in patients with chronic HCV infection

“…Considering the fact that HCMV viruses contribute an immunomodulatory effect resulting in developed of immunosuppression 43,44 and dysregulation of cytokine which could fast HCV pathogenesis of patients in critical condition. 39 CMV infection promotes HCV pathogenesis by prohibition the normal mechanisms responsible for HCV elimination, thus playing vital role in HCV existence and pathogenicity. 45 …”

“…37 Bayram et al 38 was shown that CMV was diagnosed in HBV or HCV patients as a dual infection and that it can increase the risk of the disease. In Egypt, Tabll et al 39 were examined the potential role thatCMV plays in chronic HCV progression. Also Bader El din et al, 40 demonstrate higher rate of CMV co-infection in chronic HCV patients in Egypt than other patient populations.…”