Research Article
Hepatitis C among Egyptian Patients Referred for
Bone Marrow Examination: Seroprevalence and Analysis of
Hematological Findings
Somaia Mohammed Mousa
Clinical Pathology Department, Kasr Al-Ainy School of Medicine, Cairo University, P.O. Box 99, Manial El-Roda, Cairo 11553, Egypt
Correspondence should be addressed to Somaia Mohammed Mousa; smamousa@gmail.com
Received 2 February 2014; Revised 17 March 2014; Accepted 21 March 2014; Published 10 April 2014
Academic Editor: Peter J. Quesenberry
Copyright © 2014 Somaia Mohammed Mousa. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Hepatitis C is a signifcant public health problem in Egypt where the highest prevalence (14.7%) of hepatitis C virus (HCV) exists.
HCV prevalence is even higher among clinical populations and groups at risk of exposure to infection. Chronic HCV infection is
associated with several hematological complications that may necessitate bone marrow (BM) examination. Te aim of this study is
to estimate HCV prevalence among patients referred for BM examination and to explore hematological and BM fndings among
HCV positive patients. One hundred adult patients referred for BM examination were included in the study and screened for
HCV antibodies. Patients’ clinical, hematological, and BM fndings were recorded. Te seroprevalence of HCV among patients
referred for BM examination was 42%. Te most common indication for BM examination among HCV positive patients was
peripheral cytopenias (88.1%). Te most common cytopenia detected was thrombocytopenia (85.7%). Te most common diagnosis
among HCV positive patients was hypersplenism (52.4%) followed by B-lymphoproliferative disorders (19%) and then immune
thrombocytopenic purpura (11.9%). In conclusion, HCV prevalence among patients referred for BM examination is higher than
that estimated in the general population. Patients with unexplained peripheral cytopenias should be tested for HCV.
1. Introduction
Hepatitis C virus (HCV) infection is a major health problem
in Egypt. Egypt has the highest HCV prevalence worldwide
[1]. Te estimated prevalence of HCV in Egypt is 14.7%
among general population in the year 2008 [2]. HCV preva-
lence is even higher among hospitalized patients and special
clinical populations [3]. Most HCV-infected patients have no
hepatic symptoms, and extrahepatic syndromes may be the
reason for which they seek medical advice [4]. Chronic HCV
infection is associated with several benign as well as malig-
nant hematological complications. HCV is a lymphotropic
virus [5] that could be associated with lymphoproliferative
disorders including B-cell non-Hodgkin’s lymphoma (NHL)
and monoclonal gammopathies [6]. Peripheral cytopenias
are common hematological derangements that are associated
with HCV [7]. Tey occur because of peripheral sequestra-
tion in the spleen (hypersplenism), peripheral destruction
by immune mechanism, or antiviral therapy [8]. Patients
with HCV infection may be referred for bone marrow (BM)
examination due to any of these complications. Te aim
of this work is to study the prevalence of HCV infection
among Egyptian patients referred for BM examination and to
explore hematological and BM fndings among HCV positive
patients.
2. Patients and Methods
Te study included 100 patients referred to the Hematology
Unit, Clinical Pathology Department, Kasr Al-Ainy School
of Medicine, Cairo University. Patients were referred from
diferent hospital departments for BM examination due to
various indications. Non-Egyptians and patients below the
age of 14 years were excluded from the study. Te frst
100 patients who met the study criteria were consecutively
Hindawi Publishing Corporation
Bone Marrow Research
Volume 2014, Article ID 549716, 4 pages
http://dx.doi.org/10.1155/2014/549716