Abstract
This study aimed to investigate the incidence of bacterial infection in chronic hepatitis C virus (HCV) patients with cirrhosis and association between toll-like receptor 4 D299G gene polymorphism and Gram-negative bacterial infections in the patients. 100 HCV cirrhotic patients with ascites and 20 age- and sex-matched healthy subjects as control were included. Conventional culture methods were used to identify the causative organism of infection. Toll-like receptor 4 D299G polymorphism was detected by PCR- RFLP (polymerase chain reaction – restriction fragment length polymorphism). Patients were divided into: Group I: 100 HCV cirrhotic patients with ascites. They were subdivided into: Group I (a): Patients with Toll-like receptor 4 D299G polymorphism, Group I (b): Patients without polymorphism. Group II (control): 20 healthy subjects. This study showed significant higher incidence of infections in cirrhotic patients with Toll-like receptor 4 D299G polymorphism which play a role in the development of bacterial infection in cirrhotic patients that makes down-regulation of TLR4 response one of the immune mechanisms predisposed to Gram negative bacterial infection in cirrhotic patients. Key words: TLR-4 gene polymorphism, cirrhosis, bacterial infection. 
Highlights
Hepatitis C virus (HCV) is increasing health problems all over the world
This study aimed to investigate the incidence of bacterial infection in chronic hepatitis C virus (HCV) patients with cirrhosis and association between toll-like receptor 4 D299G gene polymorphism and Gram-negative bacterial infections in the patients
This study showed significant higher incidence of infections in cirrhotic patients with Toll-like receptor 4 D299G polymorphism which play a role in the development of bacterial infection in cirrhotic patients that makes down-regulation of TLR4 response one of the immune mechanisms predisposed to Gram negative bacterial infection in cirrhotic patients
Summary
Hepatitis C virus (HCV) is increasing health problems all over the world. It affects millions of people worldwide and is considered a leading cause of liver diseases including cirrhosis and hepatocellular carcinoma. Bacterial infections are considered the most frequent and severe complications in HCV patients with cirrhosis leading.
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