Background: Hepatocellular carcinoma (HCC) is the commonest primary cancer of liver. Epidemiologic research exploring risk factors of HCC is important because of increasing frequency of the disease in Egypt with remarkable rise in noncirrhotic patients. Identifying risk factors of HCC may help in decreasing its incidence. Aim: This study was carried out to identify risk factors of HCC among both cirrhotic and noncirrhotic patients in Upper Egypt. Methods: A case control study of 104 cases with HCC against 104 controls without HCC were recruited from Tropical Medicine and Gastroenterology Department, Assiut University Hospital; patients were from the governorates of Assiut, Sohag, Qena, and Aswan. Patients were divided into two groups, cirrhotics and noncirrhotics. For all participants, the following was conducted: clinical evaluation, abdominal ultrasonography examination, and laboratory investigations. Risk factors of HCC were identified using univariate then multivariate analysis. Results: Cirrhotic patients constituted 60.6% of the total sample while noncirrhotic patients constituted 39.4%. Among cirrhotic patients, higher risk of HCC was observed with underground water use (OR 15.825, 95% CI 4.462-56.128), tobacco smoking (OR 7.755, 95% CI 2.790-21.558), and metabolic syndrome (OR 5.595, 95% CI 1.565-20.009), While risk factors of HCC in noncirrhotic patients were found to be positive HBsAg (OR 15.223, 95% CI 2.009-115.352), tobacco smoking (OR 8.349, 95% CI 2.113-32.982), metabolic syndrome (OR 7.374, 95% CI 1.635-33.266), and manual agricultural job (OR 7.001, 95% CI 1.604- 30.648). Conclusion: Distinct patterns of HCC risk factors exist among cirrhotic and noncirrhotic patients, with a common ground. The risk factor of HCC in cirrhotic patients was underground water use while chronic HBV infection and manual agricultural job were risk factors in noncirrhotic patients. For both cirrhotic and noncirrhotic patients, tobacco smoking and metabolic syndrome were common risk factors of HCC.

Background: Hepatocellular carcinoma (HCC) is the commonest primary cancer of liver. Epidemiologic research exploring risk factors of HCC is important because of increasing frequency of the disease in Egypt with remarkable rise in noncirrhotic patients. Identifying risk factors of HCC may help in decreasing its incidence. Aim: This study was carried out to identify risk factors of HCC among both cirrhotic and noncirrhotic patients in Upper Egypt. Methods: A case control study of 104 cases with HCC against 104 controls without HCC were recruited from Tropical Medicine and Gastroenterology Department, Assiut University Hospital; patients were from the governorates of Assiut, Sohag, Qena, and Aswan. Patients were divided into two groups, cirrhotics and noncirrhotics. For all participants, the following was conducted: clinical evaluation, abdominal ultrasonography examination, and laboratory investigations. Risk factors of HCC were identified using univariate then multivariate analysis. Results: Cirrhotic patients constituted 60.6% of the total sample while noncirrhotic patients constituted 39.4%. Among cirrhotic patients, higher risk of HCC was observed with underground water use (OR 15.825, 95% CI 4.462-56.128), tobacco smoking (OR 7.755, 95% CI 2.790-21.558), and metabolic syndrome (OR 5.595, 95% CI 1.565-20.009), While risk factors of HCC in noncirrhotic patients were found to be positive HBsAg (OR 15.223, 95% CI 2.009-115.352), tobacco smoking (OR 8.349, 95% CI 2.113-32.982), metabolic syndrome (OR 7.374, 95% CI 1.635-33.266), and manual agricultural job (OR 7.001, 95% CI 1.604- 30.648). Conclusion: Distinct patterns of HCC risk factors exist among cirrhotic and noncirrhotic patients, with a common ground. The risk factor of HCC in cirrhotic patients was underground water use while chronic HBV infection and manual agricultural job were risk factors in noncirrhotic patients. For both cirrhotic and noncirrhotic patients, tobacco smoking and metabolic syndrome were common risk factors of HCC.

Background: Hepatocellular carcinoma (HCC) is the commonest primary cancer of liver. Epidemiologic research exploring risk factors of HCC is important because of increasing frequency of the disease in Egypt with remarkable rise in noncirrhotic patients. Identifying risk factors of HCC may help in decreasing its incidence. Aim: This study was carried out to identify risk factors of HCC among both cirrhotic and noncirrhotic patients in Upper Egypt. Methods: A case control study of 104 cases with HCC against 104 controls without HCC were recruited from Tropical Medicine and Gastroenterology Department, Assiut University Hospital; patients were from the governorates of Assiut, Sohag, Qena, and Aswan. Patients were divided into two groups, cirrhotics and noncirrhotics. For all participants, the following was conducted: clinical evaluation, abdominal ultrasonography examination, and laboratory investigations. Risk factors of HCC were identified using univariate then multivariate analysis. Results: Cirrhotic patients constituted 60.6% of the total sample while noncirrhotic patients constituted 39.4%. Among cirrhotic patients, higher risk of HCC was observed with underground water use (OR 15.825, 95% CI 4.462-56.128), tobacco smoking (OR 7.755, 95% CI 2.790-21.558), and metabolic syndrome (OR 5.595, 95% CI 1.565-20.009), While risk factors of HCC in noncirrhotic patients were found to be positive HBsAg (OR 15.223, 95% CI 2.009-115.352), tobacco smoking (OR 8.349, 95% CI 2.113-32.982), metabolic syndrome (OR 7.374, 95% CI 1.635-33.266), and manual agricultural job (OR 7.001, 95% CI 1.604- 30.648). Conclusion: Distinct patterns of HCC risk factors exist among cirrhotic and noncirrhotic patients, with a common ground. The risk factor of HCC in cirrhotic patients was underground water use while chronic HBV infection and manual agricultural job were risk factors in noncirrhotic patients. For both cirrhotic and noncirrhotic patients, tobacco smoking and metabolic syndrome were common risk factors of HCC.

BACKGROUND/AIM: Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C virus (HCV) infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C (CHC) (necroinflammation and fibrosis) and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. PATIENTS AND METHODS: Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. RESULTS: Our study included 92 male patients. Their mean ± SD age and aspartate aminotransferase (AST) level were 42 ± 7.7 years (range 20-56) and 68 ± 41.7 U/L (range 16-214), respectively. The mean insulin level and insulin resistance index were 15.6 ± 18.3 mIU/mL (range 5.1-137.4) and 5.9 ± 15.2 (range 0.9-136.2), respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age ≥40 years, and steatosis. CONCLUSIONS: Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age.

BACKGROUND/AIM: Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C virus (HCV) infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C (CHC) (necroinflammation and fibrosis) and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. PATIENTS AND METHODS: Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. RESULTS: Our study included 92 male patients. Their mean ± SD age and aspartate aminotransferase (AST) level were 42 ± 7.7 years (range 20-56) and 68 ± 41.7 U/L (range 16-214), respectively. The mean insulin level and insulin resistance index were 15.6 ± 18.3 mIU/mL (range 5.1-137.4) and 5.9 ± 15.2 (range 0.9-136.2), respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age ≥40 years, and steatosis. CONCLUSIONS: Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age.

BACKGROUND/AIM: Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C virus (HCV) infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C (CHC) (necroinflammation and fibrosis) and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. PATIENTS AND METHODS: Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. RESULTS: Our study included 92 male patients. Their mean ± SD age and aspartate aminotransferase (AST) level were 42 ± 7.7 years (range 20-56) and 68 ± 41.7 U/L (range 16-214), respectively. The mean insulin level and insulin resistance index were 15.6 ± 18.3 mIU/mL (range 5.1-137.4) and 5.9 ± 15.2 (range 0.9-136.2), respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age ≥40 years, and steatosis. CONCLUSIONS: Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age.

BACKGROUND/AIM: Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C virus (HCV) infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C (CHC) (necroinflammation and fibrosis) and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. PATIENTS AND METHODS: Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. RESULTS: Our study included 92 male patients. Their mean ± SD age and aspartate aminotransferase (AST) level were 42 ± 7.7 years (range 20-56) and 68 ± 41.7 U/L (range 16-214), respectively. The mean insulin level and insulin resistance index were 15.6 ± 18.3 mIU/mL (range 5.1-137.4) and 5.9 ± 15.2 (range 0.9-136.2), respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age ≥40 years, and steatosis. CONCLUSIONS: Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age.

BACKGROUND/AIM: Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C virus (HCV) infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C (CHC) (necroinflammation and fibrosis) and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. PATIENTS AND METHODS: Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. RESULTS: Our study included 92 male patients. Their mean ± SD age and aspartate aminotransferase (AST) level were 42 ± 7.7 years (range 20-56) and 68 ± 41.7 U/L (range 16-214), respectively. The mean insulin level and insulin resistance index were 15.6 ± 18.3 mIU/mL (range 5.1-137.4) and 5.9 ± 15.2 (range 0.9-136.2), respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age ≥40 years, and steatosis. CONCLUSIONS: Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age.

Background and Aims: Chronic hepatitis C virus (HCV) infection is very common in Egypt. There is no available data about frequency of chronic HCV infection in patients with ulcerative colitis (UC) or effect of this infection on UC. We carried out this study to answer such questions. Methods: We prospectively analyzed 44 patients with UC from Tropical Medicine and Gastroenterology Department, Assiut University Hospital. For all participants, the following was conducted: clinical evaluation, abdominal ultrasonography (US) examination, and laboratory investigations. Differences in UC disease severity and distribution between patients with chronic HCV infection and those without were identified using univariate analysis. Results: Frequency of chronic HCV infection was 25% among study patients. Univariate analysis showed a significantly lower (p 0.05) severe UC activity index and higher moderate index in UC patients with chronic HCV infection than in those without. Conclusions: We found that frequency of chronic HCV infection among Egyptian patients with UC is similar to that among general population. Chronic HCV infection was associated with less severe activity index of UC suggesting an inhibitory role of HCV on UC activity.

Background and Aims: Chronic hepatitis C virus (HCV) infection is very common in Egypt. There is no available data about frequency of chronic HCV infection in patients with ulcerative colitis (UC) or effect of this infection on UC. We carried out this study to answer such questions. Methods: We prospectively analyzed 44 patients with UC from Tropical Medicine and Gastroenterology Department, Assiut University Hospital. For all participants, the following was conducted: clinical evaluation, abdominal ultrasonography (US) examination, and laboratory investigations. Differences in UC disease severity and distribution between patients with chronic HCV infection and those without were identified using univariate analysis. Results: Frequency of chronic HCV infection was 25% among study patients. Univariate analysis showed a significantly lower (p 0.05) severe UC activity index and higher moderate index in UC patients with chronic HCV infection than in those without. Conclusions: We found that frequency of chronic HCV infection among Egyptian patients with UC is similar to that among general population. Chronic HCV infection was associated with less severe activity index of UC suggesting an inhibitory role of HCV on UC activity.