الفهرس 
HCV INFECTIONOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) infection affects about 3% of the world population. Egypt has a high prevalence of HCV especially genotype 4a. Hepatitis C virus is a leading cause of hepatocellular carcinoma (HCC) and chronic liver disease in Egypt. Combination therapy with pegylated interferon (Peg-IFN) and ribavirin is the standard therapy for chronic HCV infection. The efficacy of antiviral therapy varies according to the genotype.
The aim of the present study was to study patients with lack of early virological response to pegylated interferon and ribavirin that used for treatment of chronic hepatitis C and to determine the factors that predict failure of the therapeutic protocol to achieve early virological response. To achieve this target, 200 patients who were treated by combined pegylated interferon and ribavirin therapy were included in the study. They comprised 166 males (83.0 %) and 34 females (17.0 %) with a mean age of 44.6 ± 6.8 years.
In the present study, early virological response was achieved in 168 patients (84.0 %) while 32 patients (16.0 %) failed to respond to the combined pegylated interferon and ribavirin therapy.
The present study noted no association between the early virological response and the demographic characteristics of patients (age, sex and BMI). In respect to the association between EVR and the associated comorbidities, the present study found no association between treatment response and the associated DM or concurrent smoking.
Comparison of the hematological parameters between the studied groups didn’t reveal significant differences regarding Hb concentration, WBCs count and platelets count. In the present study, none of the liver functions tests was found to be a predictor of EVR in the studied patients. Comparison of the other laboratory findings between the studied groups had revealed that patients who achieved EVR had significantly lower serum ferritin when compared with non-responders. Also, AFP and high viral load were found to be positive predictors for early non responders in the present study.
Regarding the relation between early virological response and the pathological findings, the present study found that early non-responders had significantly higher fibrosis score.
CONCLUSIONS
• Early virological response was achieved in 168 patients (84.0 %).
• Patients who achieved EVR had significantly lower serum ferritin when compared with non-responders.
• AFP was found to be a positive predictor for early non responders in the present study.
• Early non-responders had significantly higher viral load.
• Early non-responders had significantly higher fibrosis score.
RECOMMENDATIONS
• Pre treatment prediction of virological response to PEG – IFN- RBV therapy is still incomplete, so further studies are recommended to detect these predictors .
• More studies should be done on IL 28 as a predictor of EVR in patients with chronic hepatitis c virus.
• Modulation or adjustment of host factors as body weight , alcohol intake , insulin resistance that can affect the virological response, especially in the presence of such factors as advanced fibrosis or high viral load that may by associated with low virological response.