الفهرس 
Hepatitis C pathophysiologyOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) is the principal cause of death from liver disease and
the leading indication for liver transplantation (Kim WR ., 2007).
Mortality related to HCV infection [death from liver failure or hepatocellular
carcinoma(HCC)] will continue to increase over the next two decades (Deuffic-
Burban et al., 2007).
In 2008, a demographic health survey (DHS) was carried out in Egypt revealing
HCV antibody prevalence nationwide of 14.7 % and HCV RNA of 10 % (95 % CI
13.9–15.5 %) in age group (15–59) (El-Zanaty and Way ., 2009).
Genotype 4 is responsible for >90% of cases. The distribution of this genotype
(specifically subtype 4a) is thought to be due to the mass treatment programs for
schistosomiasis for decades until the 1980s when oral treatment became available.
(Tanaka et al ., 2004).
The current standard treatment for HCV consists of combination regimens of
pegylated interferon (IFN)- α and ribavirin (peg-IFN/RBV). The main goal of
therapy in HCV infection is to achieve sustained virological response (SVR),
currently defined as undetectable HCV RNA in peripheral blood determined with
the most sensitive polymerase chain reaction technique 24 weeks after the end of
treatment . (Deutsch and Hadziyannis 2008).
2
Alpha-fetoprotein(AFP), a 70-KDa glycoprotein encoded by a gene located on
chromosome 4, represents the major serum protein during fetal life (Lazarevich
NL ., 2000). Shortly before birth, serum AFP levels begin to fall and AFP is
replaced by albumin as the major serum protein. Serum AFP levels thereafter
remain at very low levels throughout life (typically <10 ng/ml) (Ball et al .,1992,
Matsui et al., 1998). Serum AFP levels can become elevated again in adults with
HCC, germ-cell tumors, and liver diseases (Di Bisceglie et al .,2005).
Elevated serum AFP has been used as a marker for hepatic regeneration after the
destruction of hepatocyte in viral hepatitis (Eleftheriou et al., 1977). Elevated
serum AFP levels are noted in patients with chronic hepatitis C (CHC)without
HCC.
AFP levels have been reported in some studies to be negative treatment predictor
and patients who showed high baseline AFP level before INF treatment may not
achieve a favorable treatment outcome (Males et al .,2007)
The change in AFP levels after treatment with peg-IFN/RBV combination therapy
is still a favorable research area.
The aim of the study:-
To Study the Impact of treatment of chronic HCV with Pegylated interferon
and ribavirin on Alpha-fetoprotein levels in different treatment outcomes.