الفهرس 
Hepatitis C Virus Infection ”Epidemiology and Natural history”Only 14 pages are availabe for public view
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Abstract
Treatment of HCV infected patients with child class B is challenging due to their liability to pass to decompensated child C class and to be complicated with ascites, varices and other signs of liver cell failure (Lisa M.et al, 2015). Patients with decompensated cirrhosis, no HCC and a MELD score <18-20 infected with HCV genotype 1, 4, 5 or 6 should be treated with sofosbuvir and ledipasvir for 12 weeks with ribavirin (EASL, 2016).
This study was designed to assess the safety and efficacy of sofosbuvir/ ledipasvir in infected naïve and experienced HCV Egyptian patients with decompensated liver disease.
This study was conducted in co-operation between Tropical Medicine Department, Ain-Shams University and the Gastroenterology and Hepatology Department at El Agouza Police Hospital. The work was performed in-between February 2017 and March 2018.We performed this study on 100 adult Egyptian patients with documented diagnosis of HCV infection (based on PCR results) with decompensated liver disease (Child class B).
All patients were subjected to the following; careful history taking, thorough clinical examination and laboratory investigations including liver enzymes (AST and ALT), serum albumin, INR, total and direct bilirubin, complete blood count, viral markers (HCV-Ab and HBs-Ag), serum creatinine, AFP and PCR HCV RNA . Fibroscan was done to all patients to assess the stage fibrosis. Abdominal ultrasound and Upper GI endoscopy were done for all cases.
Among the 100 enrolled patients; there was male predominance being 72 males (72%) and 28 females (28%). Their age ranged between 34 and 65 years (mean 52.7 ±8.2 years).
Among the 100 studied cases 6 patients stopped treatment; 3 of them developed HCC, 1 developed precoma, 1 died and 1 lost follow up. SGOT, SGPT, ALP, total and direct bilirubin, serum urea and creatinine and AFP showed significant improvement at the end of treatment and 3 months after end of treatment
Among the 100 HCV enrolled patients, As regards the serum albumin, INR and platelets levels, Serum albumin significantly increased, INR significantly decreased and platelets significantly increased in the whole sample
As regards Child and MELD scores among the studied cases, Child and MELD significantly decreased in the whole sample.
In conclusion, ledipasvir/sofosbuvir appears safe and effective in Child B decompensated patients.