الفهرس 
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Abstract
HCV and schistosomiasis are the most serious health burden in Egyptian community. Aim: To test the accuracy of direct and indirect fibrosis biochemical markers for the assessment of hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection with and without Schistosomaisis compared to liver biopsy. Subjects and methods: patients with HCV candidate for anti viral therapy in National Egyptian Program for treatment of HCV were included in this study, all patients were investigated for serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, total bilirubin, prothrombin time and concentration, complete blood count, hepatitis B surface antigen (HBs Ag), HCV Abs, HCV-RNA by quantitative polymerase chain reaction, abdominal ultrasound and ultrasonic-guided liver biopsy. The following ratios, scores and indices were calculated and compared with the results of the histopathological examination: AST/ALT ratio (AAR), age platelet index (API), AST to platelet ratio index (APRI) and serum Hyaloronic acid (HA) before and after end of therapy. RESULTS: There is statistical significant association between HA and interferon response to treatment (p- value < 0.01). HAA is a good sensitive, bad specific to diagnose severe fibrosis or cirrhosis (73.9%, 66.7%). AST is a good sensitive, bad specific to diagnose severe fibrosis or cirrhosis (73.9, 49.1). HA/platelets ratio is a good sensitive, bad specific to diagnose severe fibrosis or cirrhosis (73.9%, 59.3%). There is no statistical significant difference between both HCV group with bilharsiasis and HCV mono-infection regarding HA (p- value > 0.05). There is no statistical significant association between HA and fibrosis grade in mono-infection (p- value > 0.05). There is statistical significant association between HA and fibrosis grade in HCV group with bilharsiasis (p value<0.01). There is highly statistical significant difference between basal and follow up of HA (p- value < 0.01). There is no statistical significant association between HA and activity grade in each group of HCV (p- value > 0.05).. There is statistical significant association between HA and response to interferon treatment in each group of HCV (p- value < 0.05).
CONCLUSION: The use of indirect and direct (HA) biomarkers may reduce the need for liver biopsy, HA could also predict the response to interferon in the studied patients either chronic HCV mono-infection or coinfected with HCV.
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