الفهرس 
Introduction and Aim if the WorkOnly 14 pages are availabe for public view
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Abstract
The aim of this study is to assess inrta-PBMNs HCV RNA positivity and to study the distributions of HCV genotypes in some Egyptian children with CHC in both serum and PBMCs.The present study included One hundred patients(73 males; 27 females, age 14.90±2.5years; range (9-18 years) with positive HCV antibodies were enrolled in this study. HCV RNA was assessed by real time polymerase chain reactions (RT-PCR) in both serum and PBMCs. HCV genotypes were studied by RT-PCR in both serum and PBMCs.The following results were obtained:
Viremia was detected in 79 patients with median viral load 1.27X105 IU/mL. In PMNCs74 patients were positive for HCV RNA. 5 patients were positive for HCV RNA in serum but negative in PBMCs. GT-4 was detected in 97.5% of patient serum, in 89.9% of patients, PBMCs, GT-1 was detected in 5.1% of patients serum, in PBMCs 10.1% of patients had GT-1. GT-3 was only detected in 6.7% of patients PBMCs. Mixed genotypes were detected significantly in PBMCs more than serum. There was a genotype difference between serum and PBMCs of 16.5% of patients. At the end of treatment (12 weeks) with Harvoni, HCV RNA was reassessed in both serum and PBMCs by RT-PCR. All patients were negative for HCV PCR in serum (SVR 100%) and in PBMCs except only one patient (1.2%) who continued to be HCV PCR positive in PBMCs but was seronegative for HCV RNA and all laboratory investigations remained within normal range at that point. This case is of clinical significance inspite of low statistical power due to the small number, relapse was susceptible so, patient was followed up after 3 and 6 months post treatment by serum RT-PCR and seronegativity persisted without any evidence of recurrence of infection at those times of follow up.from this study we can conclude that:
1. Genotype 4 is the most common genotype in Egyptain serum and PBMCs, this contribution of genotype 4 into the Egyptian pool is not exclusive but other genetically related but different genotypes also exist as genotypes 1,3.
2. The presence of multiple (mixed) genotypes in Egyptian children in both serum and PBMCs and mixed genotypes are more frequent in PBMCs than in serum so, further studies are required to assess the impact of multiple genotype infection on clinical outcome.
3. Our data suggest the presence of OCI in at least some individuals who either spontaneously or post antiviral treatment have cleared HCV from their serum, Although, lack of viremia at the end of treatment alone does not indicate absence of circulating virus.
4. Considering serum HCV genotyping and quantitation as the target determinant for antiviral therapy alone, neglecting PBMCs HCV genotyping and quantitation may lead to viral relapse and treatment failure, an issue which should be further investigated in future work.
5. HCV genotypes involved in PBMCs need to be determined before starting antiviral therapy to outline which drug will be effective and to determine the dose and duration of antiviral therapy.