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العنوان
study of rapid decline in serum levels of soluble CD163 as a marker of fibrosis improvement with successful direct antiviral treatment of patients with chronic hepatitis C /
المؤلف
Wassfy, Wesam Essam Aly.
هيئة الاعداد
باحث / وسام عصام علي وصفي
مشرف / أحمد علي مؤنس
مشرف / هشام حمدي الكيلاني
مشرف / اميرة إسحاق سمعان
تاريخ النشر
2019.
عدد الصفحات
84 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الطب الباطني
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - الباطنة العامة والجهاز الهضمي
الفهرس
Only 14 pages are availabe for public view

from 84

from 84

Abstract

Hepatitis C virus (HCV) is estimated to infect 185 million chronically worldwide, with 3-4 million new infections per year and over 350,000 deaths due to HCV-related liver disease each year (Gower et al., 2016). HCV infection has variable long term impact ranging from minimal effects to chronic hepatitis, advanced fibrosis, cirrhosis, decompensated cirrhosis, hepatocellular carcinoma and may also induce extra hepatic complication (Maasoumy and Wedemeyer, 2016).
The main goal of HCV therapy is to eradicate it in order to prevent hepatic and extra-hepatic complications and to improve overall survival (Lavanchy, 2011). Advances in the treatment of HCV infection have demonstrated over 90% cure rates, as defined by the sustained virological response (SVR), i.e. undetectable HCV RNA 12 weeks (SVR12) or 24 weeks (SVR24) after the end of therapy. Long-term follow-up studies have shown that an SVR corresponds to a definitive cure of HCV infection in more than 99% of cases (Poiteau et al., 2016).
In light of the advances in HCV therapy, simplification of diagnosis confirmation, pre-treatment diagnostic workup and treatment monitoring is required to ensure broad access to these new therapies. Introduction of these highly potent therapies has necessated the need for response-guided therapy and follow up by markers that implicates successful response, one of these markers is the hemoglobin-haptoglobin scavenger receptor CD163, which is located exclusively on the surface of macrophages and monocytes (Gronbaek et al., 2012).
sCD163 is shed from the cell surface into the circulation upon macrophage activation, and is thus a highly specific marker of macrophage activation. The soluble form of CD163 (sCD163) has shown promising capacity as a biomarker of the severity and outcome of various liver diseases (Gronbaek et al., 2012).
The aim of this study is to assess the accuracy of the biomarker soluble CD 163 in defining the regression of liver fibrosis in patients with hepatitis C treated with direct antiviral agents in comparison to standard methods.
This prospective study was conducted on 40 patients with HCV eligible for antiviral treatment with direct acting antivirals, agreeable to regular follow up, recruited from Ain Shams University virology center in Cairo during the period from January 2019 to July 2019, after informed consents were taken from the patients and agreement for follow up and on 10 healthy control subjects.
In our study, there was a significant positive correlation between sustained virological response 12 weeks after direct antiviral agents treatment of hepatitis C and decrease in the level of serum CD163 with p-value (<0.001) as fibrosis and it shows the best cut off value of sCD163 between cirrhotic and non-cirrhotic patients before treatment is > 6.2 with 97.4% accuracy.