الفهرس 
1. Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
This prospective cohort study was conducted upon one hundred and one (101) HCV positive patients eligible for treatment with direct acting antiviral drugs (DAAs) according to the national guidelines for antiviral treatment. smoker and hypertension was present among 17% and 9% of cases respectively.
There was an association between each of sex, smoking and hypertension and baseline insulin resistance, as IR was more frequent among females(74.6%) compared to males(47.6%), nonsmoker (69.8%) more than smoker(36.8%), and hypertensive(100%) compared to non-hypertensive(59.8%).
There was improvement in liver enzyme (ALT and AST) after treatment by DAA.
There is improvement in the mean FBS after treatment, the mean fasting insulin and IR at the end of treatment was 19.24±20.97, 4.27±4.81 respectively. There is improvement in insulin resistance at the end of treatment as cases became (60 case positive for insulin resistance) and( 41case negative for insulin resistance ) but it statically non significant
There is 18 case improved (became negative for insulin resistance) and there is 14 new case developed insulin resistance after treatment most of them had a body mass index over 29.
The number of patients on dual therapy (sofosbuvir and daclatasvir) was 91 and the number of patients on triple therapy (sofosbuvir and daclatasvir and ribavirin) was 10 cases.
The 101 patients showed negative PCR at the end of treatment but 5 cases developed positive PCR 12 week after the end of treatment.
By end of treatment the number of cases who achieved sustained viral response was 96 case and the number of (relapsers) was 5 cases.
There was no significant correlation between PCR before onset of treatment and (age ,ALT, AST, Albumin, FBS, Fasting Insulin, IR).
There was a highly significant difference between males and females regarding to the PCR count with males having a higher PCR count than female.
About 38% of cases without insulin resistance at baseline developed IR at end of ttt, most of them have BMI over 29, while 28.1% of cases with insulin resistance at baseline improved after end of treatment.
There was ahighly significant correlation between the high level of HOMA IR before treatment and the occurrence of relapse.
All cases with treatment failurehave a highlevel Insulin resistance before treatment.
Also All cases with treatment failure (failed sustained viral response) have a high insulin resistance (after end of treatment).
There is no significant correlation between the baseline PCR count and the occurrence insulin resistance either before or at the end of treatment.
There is no significant correlation between thereceiving treatment regimen (dual) or (triple) therapy and the change in insulin resistance at end of treatment.
There is improvement in insulin resistance in patient receiving dual therapy at end of treatment in comparison with patient receiving triple therapy who developed more insulin resistance at end of treatment (butnon significant).
There was no significant correlation between using either dual or triple therapy on SVR 12.
There is a highly significant improvement in fasting blood sugar by the end of treatment.
There was a high significant difference between cases who developed IR after treatment and those who did not as regard BMI, with higher mean BMI among those who developed IR.
Among cases with positive PCR at 12 weeks(SVR-), the HOMA IR level was raised compared to baseline level with a mean rise of 3.37, while for responder to treatment, HOMA IR decreased compared to baseline level with a mean decrease of 0.14, however this was statistically non significant.