الفهرس 
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Abstract
HCV has become the most significant cause of chronic liver disease of infectious etiology in children. The majority of infected children have chronic asymptomatic hepatitis C with minimal histological inflammation and fibrosis. PEG-INF α 2a has been approved by the US Food and Drug Administration (FDA) for use in children aged 5 through 17 year, in combination with RBV.
To date, studies of PEG-IFN α2a in Egyptian children where genotype 4 is the predominant genotype have been limited to few studies.
Aim : The aim of the present study was to evaluate the efficacy and safety of combined treatment among Egyptian children and to evaluate the effect of variable predictive factors (including viral and host genetic factors) on achievement of sustained viral response among the treated children.
Subjects: Fifty seven children aged 5–16 years with previously untreated CHC were selected from Hepatology Clinic in Alexandria University Children’s Hospital. Selection of patients was in the duration from April 2011 up to March 2012.
Exclusion criteria : children with the following criteria are excluded from the study,coexisting other chronic liver disease , co-infection with HBV or HIV, seizures, renal insufficiency, or abnormal thyroid function, hematological disorders including sickle cell anemia or thalassemia and concomitant therapy with immunosuppressive drugs or corticosteroids.
Methods: Viral genotype was identified in the study group. Single nucleotide polymorphism at the site of IL28B (rs12979860) was evaluated as a host genetic predictor for treatment response. Pretreatment liver biopsy was assessed for all children for evidence of fibrosis and inflammatory activity using scoring system of Ishak et al. Liver steatosis was assessed . Excess hepatocellular iron and cupper were also assessed in the biopsy specimen.
Treatment plan :Treatment consisted of PEG-IFN alfa-2a (Reiferon Retard 160ug vial) in a dose of (160 ug ×body surface area) /1.73.given once per week subcutaneously and Ribavirin capsules (200 mg) given orally in a dose of 15mg/kg/day in 2 divided doses.