الفهرس 
Introduction
HelicobacterOnly 14 pages are availabe for public view
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Abstract
Cirrhosis of the liver is a diffuse process characterized by fibrosis and nodule formation. HCV is well-known etiologic factor for liver cirrhosis.
During the past few years, Helicobacter infection has been reported to be associated with certain liver diseases. It may colonize the liver and induce chronic hepatic diseases especially hepatocellular carcinoma (HCC).
The present study aimed to determine the prevalence of Helicobacter species in the liver of cirrhotic patients, with or without HCV infection.
The present study included 30 patients with hepatic cirrhosis. They were 21 males and 9 females with their age ranging between 38 and 58 years (mean 49.5 ± 5.4). Blood samples were obtained from all patients for the determination of the HCV antibody status. Also a biopsy specimens obtained from the liver and was submitted for histopathological examination to determine the stage of cirrhosis and PCR for detection of Helicobacter DNA. Finally, PCR-RFLP was done on all Helicobacter positive specimens to determine the Helicobacter species.
The severity of liver disease was determined by the METAVIR activity score. Accordingly, one patient (1/30, 3.3%) had A0 score, 4/30 (13.3%) had A1 score, 11/30 patients (36.7%) had A2 score, 10/30 patients (33.3%) had A3 score and 4/30 (13.3%) had hepatocellular carcinoma.
Out of the 30 patients, 18 (60%) were positive for the HCV antibodies and 12 (40%) had negative HCV antibody test.
Helicobacter DNA was detected in biopsy samples of 21/30 (70%) patients and only 9/30 (30%) were negative for Helicobacter DNA PCR. The most common Helicobacter species identified using PCR-RFLP technique was H.pylori 17/21 (81%) followed by H.pullorum 3/21 (14%) and H.fennelliae 1/21 (5%).
Out of the 30 patients, 16 (53%) had combined HCV and Helicobacter infection, 2 (7%) had only HCV infection and 5 (17%) had only Helicobacter infection. The remaining 7 patients (23%) had neither HCV nor Helicobacter infection.
No significant association was found between Helicobacter infection and the different age groups (P > 0.05).
There was a significant association between Helicobacter infection and sex (P < 0.05). Out of the 21 Helicobacter infected patients, 17 (81%) were males and 4 (19%) were females.
There was a highly significant association between infection with HCV and Helicobacter (P<0.01). Among the 18 positive HCV there were 16/18 (88.9%) positive Helicobacter infection. On the other hand out of the 12 negative HCV, there were 5/12 (41.7%) positive for Helicobacter.
Although no significant association was found between infection with the HCV and the severity of liver disease (P>0.05), there was a highly significant association between Helicobacter infection and the severity of liver disease as determined by the METAVIR score (P < 0.01). Also, there was a highly significant association between combined Helicobacter and HCV infection and the severity of cirrhosis (P < 0.01).
from the present study, we concluded that Helicobacter DNA could be detected in the liver of cirrhotic patients. The higher prevalence of Helicobacter infection is found in HCV cirrhotic patients, and was associated with more advanced stages of liver disease. These results support the possibility that Helicobacter infection is a risk factor for the progression of cirrhosis and HCC among HCV infected patients.