الفهرس 
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Abstract
The study aimed to clarify the direct and indirect relationship between bacteria trans-located from the intestine to the blood circulation and hepatitis C virus in patients pre and post treatment.
150 blood samples were collected from patients (75) pretreatment and (75) post-treatment, while recording the medical history of all patients, whether treated or untreated, including males and females of different ages from 20 to 60 years. Patients infected with Hepatitis C virus mostly showed no symptoms, but if they do develop symptoms, they usually include fatigue, visual dysfunction, exhaustion, nausea, fever, and muscle aches, and the appearance of these symptoms progresses as the disease progresses.
Detection of hepatitis C virus was based on Symptoms, HCV Antibodies and Qualitative and quantitative HCV Abs by Q-RT-PCR.
The obtained results found significant difference between bacterial growth in HCV patients pre and post treatment. Out of seventy five pretreated patients’ with different HCV titers, there were fifty seven gave detected bacteria, included 35 of which are short bacilli gram Negative bacteria, 22 are cocci Gram positive bacteria and 18 show no detected bacteria. On the other hand out of seventy five post treated HCV patients’ were found five samples gave detected bacteria, included four of cocci Gram positive bacteria, one bacilli Gram negative bacteria and the other 70 patients showed no growth of detected bacteria.
According to the HCV symptoms on patients pre and post treatment, patients could be divided into three groups mild, moderate and severe symptoms, First, pretreated patients’ mild symptoms showed Fever, Vomiting, and loss of appetite, moderate symptoms showed Fatigue and severe symptoms showed Liver cell failure, yellowed eyes and skin, called ”Jaundice”; Dark-colored urine; and taking longer for bleeding to stop. Second, post treated patients’ mild symptoms showed fatigue, headache and muscle pain, moderate symptoms showed anemia and severe symptoms showed fibrosis and cirrhosis.
Bacterial growth in patients with HCV pretreatment varied between short rod bacilli gram negative bacteria (58.66%) and cocci gram positive bacteria (17.33%) and some gave no growth (24%). According to these data short rod bacilli gram negative bacteria was more associated with HCV patients pretreatment. HCV patients post treatment mostly showed no bacterial growth as only five patients gave bacterial growth varied between cooci gram positive bacteria (5.3%) and short rod gram negative bacteria (1.33%).
For HCV patients pretreatment 70.5 % of patients with mild symptoms gave bacterial growth, 78.7 % of patients with moderate symptoms gave bacterial growth and 72.7 % of patients with severe symptoms gave bacterial growth which could infer that as the bacterial growth increase the disease severity increase. Second HCV patients post treated only showed bacterial growth on patients with severe and moderate symptoms while all patients with mild symptoms gave no bacterial growth which means that presence of bacteria increase the symptoms and disease severity.
Bacteria identification was based on culture plate method as each sample for patients pretreatment and post treatment were being cultured on blood agar media and incubated at 37℃ for 48 hrs. After inoccupation time the appeared colonies stained by gram stain to differentiate whether it was gram positive or gram negative and by seeing the slide under the microscope determine if it was cocci or bacilli bacteria.
Frequency of common bacteria associated with HCV by using the VITEK-2-system and compared with VITEK-2system software, Different types of bacteria could be determined from the plates of patients pre and post treatment which included Gram negative short rod bacilli bacteria like E.coli with probability (98.2%) and Klebsiella spp with probability (97.5%) and Gram positive cocci bacteria like Streptococcus with probability (96.5%) and Staphylococcus spp with probability (97.8%).
According to symptoms related to hepatitis C infection in patients pretreatment it was found that more bacterial isolates were from patients with severe symptoms while the most samples that gave no growth were from patients showed mild symptoms, from these data it could be concluded that the bacterial growth increased as the disease severity increased. There was significant difference in bacterial growth with patients post treatment as (93.33%) of patients gave no bacterial growth and the other (6.67%) who gave bacterial growth could be not related to the hepatitis C infection.
Antibiotics resistance: The isolated bacteria were tested for antibiotics sensitivity by the VITEK-2-system and most of them were multi drug resistant.