الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
 |  | from | 167 |  |  |
| | | from | 167 | | |
Abstract
Hepatitis C Virus (HCV) infection is a major global health challenge. HCV infection causes sustained inflammation of the liver, which can progress to chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma.
Until just a few years ago, anti-HCV therapy was limited to interferon (IFN-based regimens) which can cause severe side effects and result in an unsatisfactory cure rate. However, several oral anti-HCV drugs (direct acting antivirals; DAAs) have been developed over the last several years. Now, HCV can be eliminated from the infected host within 12 weeks of DAA combination therapy without noticeable side effects.
Chronic hepatitis C viral infection is associated with wide metabolic disarrangements. HCV interacts with lipid metabolism leading to steatosis, causing wide adipocytokines changes and impairs glucose metabolism leading to increased prevalence of insulin resistance (IR) and type 2 diabetes.
The aim of this study is to evaluate the Impact of Direct Acting Antivirals therapy on metabolic profiles and adiponectin serum level in Egyptian patients with chronic hepatitis C infection.
This study was performed on 100 patients who have chronic hepatitis C infection, patients were divided into two groups, group I was 50 patients were treated with (Sofosbuvir / Daclatasvir / Ribavirin) for 3 months. group II was 50 patients were treated with (Ombitasvir, Paritaprevir, Ritonavir / Ribavirin) for 3 months. With follow up changes were occurred in Fasting Lipid profile, metabolic profile and Serum adiponectin level before and after end of treatment.
In this study statistical analysis of data showed significant difference in the lipid profile in group I before and after treatment, as, we found significant reduction in serum triglycerides and a significant elevation of serum cholesterol, LDL and HDL at 12 weeks after treatment, but in group II there was no significant difference in the lipid profile except for reduction in HDL before and after treatment.
Also, we found significant reduction in fasting insulin, HOMA-IR and HBA1C at 12 weeks after treatment in group I, but in group II there was no significant difference in fasting insulin, HOMA-IR and HBA1C before and after treatment.
Also, we found that there was no significant changes in the serum adiponectin level in the both group before and after treatment.
Conclusion
Eradication of chronic hepatitis C viral infection with DAAs may affect the lipid profile As, usage of Sofosbuvir-based therapy (Sofosbuvir / Daclatasvir / Ribavirin) in difficult to treat patients lead to significant reduction in serum triglycerides and a significant elevation of serum cholesterol, LDL and HDL, while usage of Non Sofosbuvir -based therapy in compensated patients (Ombitasvir, Paritaprevir, Ritonavir / Ribavirin) lead to no significant difference.
Usage of Sofosbuvir-based therapy (Sofosbuvir / Daclatasvir / Ribavirin) in difficult to treat patients lead to changes the metabolic profile of patients. As, lead to significant reduction in fasting insulin, HOMA-IR and HBA1C after treatment. But no significant difference in the metabolic profile after treatment of compensated patients with non Sofosbuvir-based therapy (Ombitasvir, Paritaprevir, Ritonavir / Ribavirin).
Usage of DAAs (Sofosbuvir-based regimen or non Sofosbuvir-based regimen) not lead to significant difference in the serum adiponectin level after end of treatment.
Recommendations
1. More studies with larger number of patients and longer duration of follow up is recommended to more precisely determine the long term effect of DAAs on the metabolic profile, lipid profile and the serum adiponectin level.
2. The lipid changes in this study which observed in patients used some types of DAAS were interesting to the extent that long-term follow-up is strongly warranted for a better clarification of the possible role of eradication chronic hepatitis C with some types of DAAs as a potential risk for cardio vascular disease.
3. Further studies involving assessment of the effect of changes which may occur in metabolic profile and lipid profile with using of some types of DAAs in treatment of chronic hepatitis C viral infection on the long term impact on liver disease outcome.
4. Different regimens of DAAs can be studied to confirm safety and benefits of DAAs.