الفهرس 
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Abstract
Egypt has the highest worldwide prevalence of persons carrying anti-HCV antibodies. Virological diagnosis of HCV is based on the detection of direct markers (RNA and antigens) and indirect markers (specific antibodies). Quantitative HCV antigen assays could be used to monitor antiviral therapy as well as to diagnose HCV infection. The present study aimed to identify circulating HCV-antigen (HCV-NS4) in sera of HCV infected patients in comparison with polymerase chain reaction (PCR).Materials and Methods: The present study included 400 subjects. Blood samples of 300 patients with different liver pathologies (liver fibrosis, liver fibrosis and HCC) were collected from Mansoura University Hospitals, Mansoura, Egypt. They were classified pathologically into three main groups : patients with liver fibrosis (group I); patients with liver cirrhosis (group II) and patients with hepatocellular carcinoma (HCC) (group III). In addition, 50 HCV asymptomatic individuals and 50 healthy individuals were included to serve as controls. Patients with other causes of chronic liver disease were ruled out. Results : The purified HCV-NS4 antigen and a serum sample from chronic hepatitis C was identified using polyacrylamide gel electrophoresis (SDS-PAGE) technique. The antigen was identified immunologically in sera of chronic hepatitis C patient and in the TCA precipitate of the purified fraction from sera of chronic hepatitis C patients at 27-kDa. Comparison between the detection of HCV-NS4 by ELISA technique and PCR technique supports the reliability of HCV-NS4 antigen detection. We detected HCV-RNA in 69% of patients with different liver pathologies while, HCV-NS4 antigen was detected in 71% of the same patients using ELISA. This makes HCV-NS4 antigen detection superior to PCR results. Also, accuracy of HCV-NS4 antigen for discriminating patients with different liver pathologies from those healthy individuals was measured.In conclusion, the detection of HCV-NS4 antigen in sera of HCV infected individuals by ELISA appears to be a promising alternative approach for laboratory diagnosis of HCV infection.