الفهرس 
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Abstract
Summary And Conclusion
Hepatitis C is a worldwide problem with a prevalence estimated to be 3% according to the World Health Organization (WHO) about 130-150 million people worldwide are chronically infected with hepatitis C virus (HCV).). Egypt has the highest prevalence of HCV estimated to be 7.3% with predominance of genotype 4
Acute HCV infection usually lead to no symptoms and about 75 % of cases infected with HCV reach a chronic stage leading to chronic HCV infection.
Sequelae of chronic HCV may lead to liver cirrhosis in nearly 20-50 % of patients infected, this may be complicated by liver cell failure and hepatocellular carcinoma later on and can occur relatively rapidly
Direct -acting antiviral agents (DAAs) are highly effective and well tolerated in patients with chronic hepatitis C virus infection, including those with compensated cirrhosis.
The availability of potent, well‐tolerated direct‐acting antiviral agents (DAAs), which can be administered in short, interferon (IFN)‐free regimens, has improved the management of patients with HCV infection dramatically. Clinical studies have demonstrated rates of sustained virologic response (SVR) of over 90% with these regimens, even in patients with compensated cirrhosis.
Achievement of SVR with IFN‐free regimens in patients with cirrhosis decreases hepatic decompensation, HCC, and liver‐related mortality .
In our study we showed the impact of DAAs on chronic hepatitis C cirrhotic patients and we detected the changes that occurred in Child Pugh score , ultrasound, APRI & FIB4 scores. We found that 92% of patients stayed in Child A but 3 patients worsened to Child B and 5 patients worsened to Child C.
Development of HCC in our study was in 4 patients, one of them assosciated with PV thrombosis.
In conclusion, direct-acting antiviral treatment is assosciated with high rates of SVR, although not associated with a significant decrease in the development of hepatic decompensation or hepatocellular carcinoma in the first year of follow-up compared to literature reports for untreated compensated cirrhotic patients. On the other hand, there is a statistically significant improvement in ALT, AST, platelets count showing a possible improvement of the hepatic function in the short term. More studies are needed to determine the benefits of direct-acting antiviral therapy in the long term.