الفهرس 
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Abstract
Hepatitis c virus is global health burden and major health hazard in Egypt, since the virus is the etiological factor of chronic hepatitis that frequently progress to a cirrhosis and hepatocellular carcinoma (HCC). In addition to cirrhosis and hepatocellular carcinoma, HCV is thought to cause metabolic alterations, including steatosis, dyslipidemia, insulin resistance (IR), diabetes, obesity, and cardiovascular events . Fibrosis and subsequent cirrhosis is lengthy process that needs years to develop. This process is also potentially reversible over time with treatment of HCV infection. The advent of oral direct-acting antivirals (DAA) has modified the prognosis of hepatitis C, since HCV eradication occurs in most treated patients with The achievement of sustained virological response 12 weeks after completion of treatment (SVR12) has been associated with improvements in liver function, and declines in clinical complications and all-cause mortality
Leptin is secreted mainly by white adipose tissue, and levels are positively correlated with the amount of body fat .leptin is involved in regulation of energy homeostasis, neuroendocrine function, metabolism, regulation of immune function and bone metabolism. It also acts as a profibrotic adipocytokine in liver fibrosis
The aim of this study was to evaluate the Impact of Direct Acting Antivirals therapy on serum leptin level in egyptian patients with chronic hepatitis C infection in correlation with fibroscan as a marker of hepatic fibrosis
This prospective study was conducted on 40 chronic HCV infected patients have received antiviral treatment with DAAs and 10 normal subjectives.
There was improvement of overall liver functions after treatment with DAAs and achieving SVR.In the current study we used transient elastography (fibroscan) to asses the degree of fibrosis of all patients before and after treatment and there was significant regression of degree of fibrosis after treatment with DAAs in all patients achieving SVR
the current study showed that leptin level was significantly higher among patients with chronic hepatitis c than normal persons but there was no significant variation in leptin between baseline and 12 weeks post treatment , unlike fibroscan which showed marked reduction of fibrosis after treatment.
This study showed that the best leptin level in prediction of hepatic fibrosis stage 4 (advanced cirrhosis) was >80 pg/ml and has sensitivity of 100% while the specificity was 40%. The positive predictive value was 35.7% while the negative predictive value was 100% .the test accuracy was 63.5%.