الفهرس 
HEPATITIS C VIRUS (HCV)Only 14 pages are availabe for public view
 |  | from | 205 |  |  |
| | | from | 205 | | |
Abstract
Hepatitis C Virus (HCV) infection is a worldwide public health concern, previously, a standard of care for chronic HCV infection was the combination of pegylated interferon (PEG‐IFN) and ribavirin (RBV). With the introduction of direct‐acting antivirals (DAAs), HCV treatment has been revolutionized, as HCV infected individuals could achieve sustained virological response (SVR) rates >90%. It has been shown that SVR is associated with a reduced risk of the progression of cirrhosis and HCC development.
An accurate assessment of liver fibrosis stages is necessary for the management of patients with chronic HCV infection. Although, liver biopsy has been considered a gold standard in assessing liver histopathology, this procedure has some limitations because of its potential of life‐threatening complications and sampling errors. In addition, the longitudinal evaluation of liver fibrosis is restricted due to the invasiveness of the procedure. An alternative non‐invasive tool to measure the severity of liver fibrosis is transient elastography (TE), which has been validated.
Besides imaging‐based techniques, several serum fibrosis markers have been applied to evaluate the extent of liver fibrosis. Recently, the serum Mac‐2‐ binding protein glycosylation isomer (M2BPGi) has emerged as a novel non‐invasive marker for liver fibrosis, particularly in patients with chronic HCV infection. Consequently, the aim of this study was to investigate the clinical utility of Mac-2 binding protein glycosylation isomer in assessment of liver fibrosis in chronic HCV patients baseline and after DAAs therapy.
This case control cohort study was conducted on 98 patients with chronic HCV (HCV Ab by ELISA) confirmed by a positive reverse transcription polymerase chain reaction (RT-PCR). In addition to 100 healthy participants (With no evidence of liver diseases) as a control group. Patients and controls were selected from inpatients and outpatient clinics of the Tropical Medicine department and HCV- treatment clinic, National Liver Institute (NLI), Menoufia university between May 2021 and August 2022.
For all participants an explanation about the study was provided together with informed consents were obtained from each one before enlisted in the study. The study was carried out after approval from the faculty of Medicine, Menoufia university’s ethical committee, and according to the Helsinki Declaration.
Patients and controls were classified into the following groups:
group I: Included 98 treatment-naïve chronic HCV patients.
group II: Included 100 healthy participants (control group).
For this purpose, all patients were subjected to the following: Full history taking, full clinical examination, laboratory evaluation with calculation of fibrosis scores including Serum Mac-2 Binding protein glycosylation isomer (M2BPGI) and FibroScan imaging, which were performed for all patients before starting treatment, and 24-weeks posttreatment including RT-PCR to determine SVR24.
Statistical analysis of the presenting data revealed:
There was a statistically non-significant difference between the two studied groups regarding sex, age, and the body mass index. The history and clinical examination distribution of studied patients (group I) showed that 10 patients had hypertension, 15 had diabetes mellitus, hepatomegaly in 37, and splenomegaly in 26 patients.
Laboratory investigations between the two studied groups before treatment revealed that, chronic HCV patients showed significantly lower values of haemoglobin concentration, platelets count and serum albumin than controls. While ALT, AST, total & direct bilirubin, PT, INR and AFP were all significantly higher in chronic HCV patients compared to control group.