الفهرس 
Introduction and aim of work
Schistosomiasis mansoniOnly 14 pages are availabe for public view
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Abstract
Background: Schistosomiasis is a severe, debilitating parasitic disease currently affecting 250 million people in the tropics, resulting in 20 million individuals with severe morbidity and 280,000 deaths annually. S. mansoni is one of the four major species of medical importance and infects over 83 million people in Africa and the Middle East. Granulomatous inflammatory response to S. mansoni eggs entrapped in the liver induces hepatic oxidative stress, with production of ROS and reduced anti-oxidant status of the organ. Coinfection with HCV and S. mansoni is associated with accelerated deterioration of hepatic function. Liver fibrosis is the common consequence of chronic liver injury of any etiology and oxidative stress appears to be very common feature Aim of Work: The present study was designed to evaluate the correlation between MDA as marker of oxidative stress and serum level of anti-oxidant in patients infected with S. mansoni. In addition, to determine if oxidative stress contributes to progression of S. mansoni disease. Methods: The studied cases were classified into the following groups: Group 1: Twenty patients with schistosomal hepatic fibrosis (12 males and 8 females), with mean age 41.45 ± 4.59 years. Group 2: Twenty patients with chronic HCV (10 males and 10 females), with mean age 42.55 ± 5.55 years. Group 3: Twenty patients with Schistosoma and HCV co-infection (14 males and 6 females), with mean age 40.75 ± 3.48 years. In addition, 20 apparently healthy controls (10 males and 10 females) with mean age 42 5.39 years were recruited in the study. All participants were subjected to: History taking, complete clinical examination, laboratory investigations including stool analysis, rectal snip in patients with negative stool for S. mansoni eggs, complete blood count, liver function tests (INR, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, albumin and total bilirubin), serum assay of total bile acid, malondialdehyde (MDA) total anti-oxidant capacity (TAC), anti-HCV by ELISA, HCV-RNA titers, HBsAg by ELISA and Schistosoma indirect haem agglutination (IHA). Abdominal ultrasound was also done for all subjects. Liver biopsy for pathological assessment of hepatic fibrosis and histological activity index in patients with chronic HCV and shistosomiasis co-infected with HCV was performed. Results: There were statistical significant differences between the HCV and mixed groups as regards PCR, Ishak score of fibrosis and Ishak score of histological activity index. Pure bilharzial patients showed a highly significant decrease in total anti-oxidant capacity (TAC) activity and increase in serum level of malondialdehyde (MDA) in comparison to control subjects. Hepatitis C virus infected patients showed significant increase in MDA level in comparison to pure bilharzial subjects with no significant difference between the two groups as regards bile acid and TAC. A significantly higher concentration of serum level of bile acid was observed in the mixed subjects in comparison with that of the pure bilharzial group. There was also significant higher concentration of serum level of TAC in pure bilharzial group in comparison with that of mixed group. Whereas, the increase in serum MDA in mixed group in comparison with that of pure bilharzial group was not statistically significant. Conclusion: There were significant correlation between MDA, TAC and bile acid levels with hepatic periportal fibrosis score by ultrasound, and bile acid level was the only predictor for hepatic periportal fibrosis in pure bilharzial patients.