Cytokine profiles and hepatic injury in occult hepatitis C versus chronic hepatitis C virus infection.

Occult hepatitis C virus (HCV) infection is a new entity that should be considered when diagnosing patients with abnormal liver functions of unknown origin. This work was carried out to evaluate T-helper 1/T-helper 2 (Th1/Th2) cytokine profiles in patients with occult HCV infection versus chronic hepatitis C (CHC) infection, also to investigate any association between theses cytokines and liver histological features in both groups. Serum levels of Th1 cytokines (IL-2, IFN-gamma) and Th2 (IL-4 and IL-10) were measured in 35 patients with occult HCV infection compared to 50 patients with chronic hepatitis C infection and 30 healthy controls. We have found that Th1 cytokines were significantly increased in patients with CHC infection than in both occult HCV infection and control groups (p less than 0.001). On the other hand, serum IL-4 levels were higher in occult HCV infection than in CHC and control groups (p less than 0.001). Furthermore, serum IL-10 levels were higher in both patient groups vs control group (pless than 0.001), with no significant difference between CHC and occult HCV groups. Finally, only serum IL-10 levels were significantly higher among patients with high activity (A2-A3) than those with low activity (A0-A1) in both CHC and occult HCV groups (p=0.038, p=0.025, respectively). Patients with occult HCV infection exhibited a distinct immunoregulatory cytokine pattern that is shifted towards the Th2 arm.

[Upper digestive system hemorrhages in Cameroon (apropos of 172 cases examined via endoscopy)]. / Les hémorragies digestives hautes au Cameroun (à propos de 172 cas explorés par endoscopie).

172 cases of upper gastrointestinal bleeding were explored endoscopically from 01 March 1987 to 15 May 1989 in 3 centers in Cameroon. The patients comprised 124 men and 48 women with an average age of 39.64 years. Haematemesis with resultant melena constituted the most frequent presentation (42.36%) while haematemesis and melena was the unique presentation in 37.22% and 17.91% of cases respectively. The aetiologic factors encountered were: duodenal ulcers (33.64%), acute gastric bleeding (22.08%) gastric ulcer (13.44%), ruptured gastroesophageal varices (13.92%). Predisposing factors included the ingestion of gastric irritant medication, spices and alcohol. The authors review the literature and in its light, discuss the epidemiology and aetiology of gastrointestinal bleeding in Cameroon.