الفهرس 
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Abstract
HCV infection is one of the leading causes of chronic hepatitis, cirrhosis, and liver cancer with an estimated worldwide prevalence of 2.27% of the general population or 170 million people.[4] Egypt has the highest worldwide prevalence of hepatitis C virus (HCV), with an estimated 8 - 10 million among a population of 75 million having been exposed to the virus and 5 - 7 million active infections.[196]
Chronic hepatitis C was treated with interferon (IFN)- monotherapy, but the combination therapy with ribavirin increases the sustained-response rate and therefore is currently the recommended treatment for HCV infection .[214]
Studies indicate that in most patients with chronic hepatitis C, viral RNA is present not only in plasma but also in PBMC. Furthermore, the PBMC compartment may be a preferred site for HCV, which is able to reinitiate viral replication after termination of HCV treatment. Even if clearance occured [216, 217]
The aim of this study was to compare the persistence of hepatitis C viral RNA in both serum and PBMCs at 12 and 24 week of treatment (pegylated interferon combined with ribavirin) in 25 patients with chronic hepatitis C virus who have negative hepatitis C RNA at week 12.
The present study included 25 CHC patients with EVR to combined treatment of pegylated interferon with ribavirin. All relevant informations were collected from patients. The following laboratory investigations were done for each patient; ALT, prothrombin activity and platelet count. The patients were tested for HCV- RNA positivity both in serum and PBMCs on the 24 weeks.
Out of 25 CHC patients included in this study, 17(68%) were females and 8 (32%) were males.
Out of 25 CHC patients included in this study, 3(12%) were between 25 to 35 years and 15(60%) were between 36 and 45 and 7 were between 46 and 60 years old.
Based on ultrasonography (U/S) results of the 25 chronic HCV patients included in this study, 13 cases (52%) had normal liver picture 5 cases (20%) had Fatty liver and 7 cases (28%) had liver cirrhosis.
Out of 25 chronic HCV patients included in this study 17 cases (68%) were found with elevated liver function levels and 8 cases (32%) had normal levels before the start of the treatment.
Among 25 cases included in this study 2 cases (8%) had viral load less than 104 and 13 cases (52%) had viral load ranging from 104 to less than 106 and 10 cases (40%) had viral load more than 106 before the start of the treatment.
Out of the 25 CHC patients included in this study, 5 cases showed positive HCR RNA in their PBMCs (20%), 3 of them (12%) at week 12 of treatment despite the absence of HCV RNA in their serum. And 2 other cases (8%) showed positive HCV RNA in PBMCs at week 24 of combined treatment, one of them also had positive HCV RNA in serum.
In the present study, no correlation was found between either age and cirrhosis or age with viral load. Also no correlation was found either between viral load and cirrhosis or viral load with viral enzymes.
In conclusion, detection of HCV RNA in PBMCs may be important to assess the virological response to interferon treatment. Follow up studied are required to assess if nonclearance of HCV RNA in PBMCs may be a predictor of unsatisfactory response to antiviral therapy followed by formulation of the duration of antiviral therapy in chronic hepatitis C.