الفهرس 
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Abstract
Hepatitis C is an infectious disease caused by hepatitis C virus (HCV) which mainly attacks the liver cells.
Near eighty percent of patients develop CHC that after many years may lead to cirrhosis or liver cancer.
Egypt has the highest prevalence rate of HCV in the world. About 14.7% of the Egyptian people have HCV antibodies and 9.8% have an active infection.The death rate due to liver disease about 40,000 each year (near 10% of all deaths). It is the second after the cardiac diseases.
With the ultimate goal of achieving a more potent strategy to control transmission of HCV in Egypt, The Ministry of Health has set up 32 specialized centers for the nationwide therapy of HCV infection.
Standard treatment for chronic hepatitis C infection was pegylated-interferon (Peg IFN) and ribavirin (RBV).
New era for management of chronic HCV using direct antiviral agents (DAAs) started in 2013.
The aim of this study is to detect accuracy of core antigen in Egyptian cirrhotic patients with HCV Infection treated with combination therapy of Sofosbuvir, Daclatasvir and Ribavirin as an alternative to PCR.
This study has been conducted at Viral Hepatitis Unit – Ahmed Maher Teaching Hospital – National committee for the control of viral hepatitis (NCCVH) during the period from February to July 2018.
The study included 23 Egyptian treatment-naïve chronic hepatitis C patients with cirrhosis (Cirrhosis was diagnosed on ultrasound basis) on Sofosbuvir, Daclatasvir and Ribavirin.
Patients subjected to
History and full physical examination
Radiology as
Abdominal Ultrasound.
Follow up with
CBC, AST, ALT, Total bilirubin, Albumin, creatinine and Coagulation profile before and after 12 weeks of treatment.
HCV RNA by PCR and HCV CORE Antigen before and then after 12 weeks of treatment.
The results of the study showed that:
• Treatment with sofosbuvir plus Daclatasvir and Ribavirin for 12 weeks resulted in undetectable HCV RNA by PCR in 95% (19/20) of the patients at the end of treatment.
• 5% (1/20) of the patients achieved SVR after 6 months not 3 (we repeated both HCV RNA testing by PCR and HCV core antigen test after 6 months from the end of treatment because he didn’t achieved SVR after 3 months and the result was negative for both tests.
• 3 patients had discontinued treatment 2 due to occurance of hepatic encephalopathy and the last was due to haematemesis.
• There is a correlation between HCV RNA and HCV core antigen results, so HCV core antigen can be used as an alternative measur ti HCV RNA in treatment of HCV infected cirrhotic patients receiving Sofosbuvir, Daclatasvir and Ribavirin.