الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Infection with hepatitis C virus (HCV) is a common prob¬lem worldwide, affecting millions of people across all populations. Most acutely infected patients develop chronic hepatitis and become a potential source of virus transmission, and as many as 1 in 5 will develop cirrhosis and its complications. Approximately 75%-85% of people infected with HCV will develop chronic hepatitis, 60%-70% will develop hepatic steatosis or fibrosis, 5%-20% will develop cirrhosis and in 1%-5% disease will progress to life-threatening complications and HCC, within 20 years from acute infection. In Egypt, the country with the highest HCV prevalence, mainly Genotypes 4.
In fact, epidemiological and molecular evolutionary studies in Egypt relate the origin of the HCV-4 epidemic to the mass campaigns of intravenous schistosomiasis treatment in rural areas in the 1960s to 70s.
The current standard of care for hepatitis C virus patients is combination treatment with pegylated interferon (Peg-IFN) and ribavirin. The aim is to achieve SVR. The duration of treatment is generally 24 weeks (genotypes 2 and 3) to 48 weeks (genotypes 1, 4 and 5). Recent advances in knowledge of the hepatitis C virus lifecycle and structural features of hepatitis C virus proteins has spurred the development of directly acting antivirals (DAAs).
In particular, HCV infection is associated with multiple metabolic derangements which, collectively, are referred to as hepatitis C associated dysmetabolic syndrome (HCADS), Some of such metabolic derangements, e.g.insulin resistance (IR) and hypocholesterolemia had been earlier identified, others (e.g., hyperuricemia and altered body fat distribution) have been recognized more recently.
FGF21 has also been suggested to be a biomarker, which could predict and differentiate liver disease, predict NAFLD development but also classify the grades of steatosis, In human HCC, a high level expression of FGF21 protein was demonstrated in grade 1 HCC but not grade 2 and grade 3 tumor cells.
It may also have potential as a therapeutic agent for disease. As, FGF21 administration has shown beneficial effects in lipid metabolism, and decrease in lipid parameters and may play a pivotal role in NAFLD therapy.
To fulfill this aim, we enrolled 80 patients with chronic hepatitis C selected from Hepatology Center of one day surgery, samalout from November 2015 to January 2017.