الفهرس 
HEPATITIS C VIRUSOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) is a major public health problem with an estimated 170 millions person being infected with this agent around the World. Egypt has the highest HCV prevalence world wide. HCV is an important cause of chronic liver disease in many parts of the world. (HCV) Virus is a positive stranded RNA Virus classified as family flavivirdae, genus hepacivirus ( HCV ) causes both acute and chronic hepatitis. The molecular mechanisms underlying lack of therapeutic response remain unknown. Considering the length of antiviral therapy, as well as its side effects and costs, accurate prediction of treatment response prior to initiation of treatment is critical. A number of host and viral related factors have been identified that influence treatment outcomes and independently predict response to treatment The objective of the present study was to retrospectively evaluate the effect of some of host and viral parameters on virological response to antiviral therapy in chronic HCV patients of genotype 4 and the Predictors of response to the proposed treatment. This study has been conducted on 70 childeren suffering from chronic hepatitis C who were previously diagnosed and treated in Shebeen EL-kom liver institute andYassin Abdel-Ghaffar Center in Cairo The studied cases were allocated to one of the following two groups Group A :(n=43) received standard Interferon Alph ( 3 million IU/m2 of body surface area subcutaneously three times per week) and Ribavirin combination 15 mg/kg /day in 2 doses) for 48 weeks. Group B:(n=27) received pegylated Interferon Alph ( 1.5 ug/kg body weight once per week subcutaneously ) in combination with oral Ribavirin (15 mg/kg / day in 2 doses) for 48 weeks. All patients were subjected to: history taking, clinical examination, BMI was calculated, routine laboratory investigations as a preparation of IFN therapy (which included CBC, complete liver biochemical profile, serum creatinine, , AFP, , Free TSH, HBsAg and Quantitative HCV RNA by PCR), Abdominal ultrasonography, liver biopsy for histopathology assessment according to METAVIR. End virological response to treatment was correlated with the following parameters : - Demographic factors (age, gender and BMI) - Liver biochemical profile (Total bilirubin, Alkaline phophatase, , AST and ALT) - Viral kinetics: HCV viral load - liver Histopathology: stage of fibrosis and grade of activity according to METAVIR score. - blood parameters ( HB, Platelet, WBCs) The results of this study showed that virological responders were 20 out of 43 patients (46.5%) while23patients (53.5%) failed to achieve response in stander interferon group. In pegylated interferon group Responders were 10 out of 27patients (37.0%) while17patients (63.0%) failed to achieve response. from the results of our study we can conclude that:
- There are a comparison between BMI and response to combined therapy and BMI could be considered as predictor of response to therapy.
- children with either mild or without steatosis has better response rates than those with the moderate steatosis in both groups of interferon based therapy and could be used as a predictor of response to treatment.
- fibrosis (stages F2-F3 according to Ishake Score) is associated with better virological response compared to (stages F0-F1) Thus there was a highly significant difference as regard the effect of fibrosis on virological response and fibrosis stage could be considered as predictor of response to therapy.
- RVR and EVR were strong predictors of treatment outcome in childeren with end of treatment virological response.
- The current study couldn’t demonstrate statistically any significant correlation between end virological response to treatment and any of the following: inflammatory activity grade, liver profile (serum AST, ALT, total bilirubin, albumin, alkaline hosphatase), type of interferon, CBC parameters (HB, WBCS, Platelet) and baseline viral load .