الفهرس 
Hepatitis COnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus is one of the most important causes of chronic liver diseases. Chronic liver disease is account for about 20% of acute viral hepatitis, 60% of chronic hepatitis, and 30% of liver cirrhosis and cancer liver. About 20% of patients with hepatitis can develop cirrhosis within 10 to 20 years of infection.
Chronic hepatitis C is diagnosed by anti-HCV antibodies, liver function tests (SGOT, SGPT, PT, alkaline phosphatase, S.albumin and bilirubin), alpha-fetoprotein and HCV-RNA (by polymerase chain reaction). Liver biopsy is the golden standerd in diagnosis of chronic liver histopathological changes.
Alpha-fetoprotein is a major plasma protein produced by the yolk sac and the liver, its level is elevated with various diseases such as chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. It also can increase with other diseases such as cancer stomach, cancer colon, testicular tumor breast cancer and ataxia-telangiectasia.
The current treatment of hepatitis C is the combination of pegylated interferon and ribavirin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype.
In this study, the aime is to use AFP as a routine laboratory investigation to predict the response to treatment with interferon and ribavirin. Data of 200 patients with chronic hepatitis C were collected who attended to Liver Research Center, Tanta Liver Research Center, Egypt, during the period from March 2008 to July 2009. The study includes 148 males and 52 females of ages ranged between 20 and 56 years. The data collected from included age, gender and weight of the patients, laboratory investigations (SGOT, SGPT, alkaline phosphatase, prothrombin concentration, s.bilirubin, s. albumin, complete blood picture and erythrocyte sedimentation rate) and polymerase chain reaction (PCR) before start of treatment and after 3 and 6 months of the start of treatment. In the center, hepatitis C and B markers were done by ELISA technique, abdominal ultrasound for all patients and liver biopsy was also done before the start of treatment to assess the degree of fibrosis by METAVIR score and to determine the decision of treatment.
Serum AFP was done before the start of treatment and after 24 weeks and after 48 weeks. The results of this study revealed significant increase in AFP with chronic hepatitis C patients. There was a direct correlation between AFP and degree of liver fibrosis as regard METAVIR score.
There was direct insignificant correlation between AFP and degree of hepatic fibrosis in patients with chronic liver disease.
There was direct significant correlation between AFP and liver function tests (SGOT, SGPT and s. bilirubin) as regard investigations.
There was inverse significant correlation between AFP levels and prothromin concentration and also, inverse significant correlation between AFP levels and serum albumin as regard investigations.
There was also significant positive correlation between HCV RNA titers (by PCR) and AFP levels before the start of treatment, after 24 weeks of treatment and 48 weeks of treatment. Low levels of AFP before the start of treatment predict better response to antiviral therapy.