Hepatitis C virus (HCV) is a serious pathogen with epidemic ≥ 170 millions and Egypt considered the highest,
while immunocompromised chronic HCV patients suffer from serious microbial infections especially bacteria. Aim: investigation
of common bacterial infections in patients with chronic HCV in Egypt and its association with HCV severity. Methods: This
clinical study was conducted on chronic HCV patients and healthy individuals, while urine and blood samples were collected
under optimized conditions. Bacteria were isolated from urine samples and identified using VETIK2 system. Flow cytometry was
used for CD56+ and CD3+ levels detection. Alanine/Aspartate aminotransferase (ALT, AST) levels were detected biochemically,
enzyme-linked immunosorbent assay (ELISA) was used for diacylglycerol acyltransferase-1 (DGAT1) level detection and HCV
PCR was performed for viral load detection. The results: showed that Staphylococcus lentus, Staphylococcus aureus, Klebsiella
pneumoniae, Pseudomonas aeruginosa and Eschirechia coli were the common bacterial infections. The slight reduction in
CD3+and CD56+ levels were coincident with the increase of Alt, AST and DGAT1 levels as patients suffered from high HCV
load. Conclusion: HCV patients are immunocompromised and suffer from serious secondary bacterial infections which increased
the severity of HCV infection.