الفهرس 
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Abstract
Hepatitis C virus (HCV) accounts for a sizable proportion of cases of chronic liver disease, liver
disease deaths and cases of hepatocellular carcinoma and represents the most common indication for liver
transplantation ,approximately 3% of the world’s population (roughly 170-200 million people) infected
with hepatitis C virus with considerable regional variations , In egypt, The seroprevalence in the age
groups 15–59 years was 10% (compared to 14.7% in the 2008 DHS).. HCV is currently the most
significant public health problem in Egypt
Patients with cirrhosis should be treated when possible for the underlying liver disease to stop
disease progression.The goal of treatment in chronic HCV infection is to achieve virological cure, thereby
reducing all-cause mortality and liver-related health adverse consequences, including end-stage liver
disease and HCC.The aim of the Study is to detect the Efficacy and safety of direct antiviral agents in
treatment of compensated cirrhotic naïve patients due to chronic HCV infection.
This study was conducted on (300) patients with chronic HCV who attended El-fayoum general
hospital , who received therapy, from January 2015 to June 2016. Patients were distributed on four
groups of treatment regimens each group incuded 75 patients ,group (I) received "Sofosbuvir &
Ribavirin ", group (II) received " Sofosbuvir & Ribavirin & Interferon", group (III) received "
Sofosbuvir & Simeprevir ", and group (IV) received " Sofosbuvir & Ribavirin & Daclatasvir", they were
naïve to treatment. All patients were subjected to clinical assessment, laboratory investigations, and
followed up fo 12 weeks and had PCR for HCV to detect treatment response .only 3 patients didn’t
contiue follow up schedule (N.B, from group one,two patients had hematemsis and died before follow up
PCR result also one patient didn’t continue treatment for unknown cause )
Our study noticed the incidence of some adverse effects during treatment that were mild to moderate
and didn’t affect completion of treatment as (Anemia ,Fatigue ,Photosensitivity ,Weight loss
,Thrombocytopenia ,Itching ,Headache and Herpes zoster) except 2 patients had hematemesis and died
after end of treatment before testing for SVR , In group 1 anemia 11(14.7%) ,fatigue4(5.3%)
photosensitivity1(1.3%) ,weight loss 3(4%) , thrombocytopenia 1(1.3%),itching1(1.3%) , headache
6(8%),herpes zoster 1(1.3%). In group 2 anemia6(8%), fatigue 8(10.7%) , weight loss 4(5.3%),
thrombocytopenia5(6.7%) ,itching 3(4%), headache 4(5.3%), In group 3 anemia 3(4%),fatigue 3(4%),
photosensitivity3(4%) ,weight loss3(4%), headache 3(4%),. In group 4 anemia 8(10.7%),fatigue
6(8%),weight loss3(4%) , headache 7(9.3%).
According to treatment response (patients achieve SVR ,12 weeks after end of treatment ), in group 1
patients achieved SVR 53(70.7%),and those didn’t were 2 died before confirming treatment response
2(2.6%) and 1 patient missed during therapy 1(1.3%) and relapsed 19(25.3%), in group 2 patients
achieved SVR 63(84%) and relapsed 12(16%), in group 3patients achieved SVR 69(92%) and relapsed
6(8%), in group 4 patients achieved SVR 68(90.7%) and relapsed 7(9.3%).
Our results revealed that DAAs are safe and effective in treatment of patients infected with HCV and
had compensated liver cirrhosis with better results in whom treated with" Sofosbuvir & Simeprevir " or "
Sofosbuvir & Ribavirin & Daclatasvir" than whom received "Sofosbuvir & Ribavirin ", or " Sofosbuvir
& Ribavirin & Interferon" regimens.