الفهرس 
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Abstract
HCV infection is a global health issue and one of the major
causes of chronic liver diseases, Egypt on the top of the countries
with heavy HCV burden, HCV genotype 4 is the most common in
Egypt and represents 92% of total infections.
The goal of HCV therapy is eradication of the HCV which
determined by sustained virological response (SVR) in order to
prevent the complications which include liver fibrosis, cirrhosis,
portal hypertension and hepatocellular carcinoma.
The availability of direct acting antiviral drugs (DAAs)
improves rates of sustained virological response (SVR). Viral
eradication decreases liver damage by improving the inflammation,
as well as by regressing fibrosis irrespective of the treatment regimen
of DAAs. Non-invasive methods are useful in the assessment of liver
fibrosis, but their usefulness for monitoring fibrosis after SVR needs
to be demonstrated.
Portal hypertension is a common complication of liver cirrhosis
which leads to the formation of gastroesophageal varices when
HVPG ≥10 mmHg which is called clinically significant portal
hypertension.
This aim of our study was to asses changes on the size of
esophageal varices and liver stiffness after treatment of HCV with
DAAs.
The study was carried out at Gastroenterology and hepatology
Department, Ain-Shams Hospital and Kobry-Elkoba Military
Hospital and included 60 patients with chronic infection of hepatitis c
Summary
146
virus diagnosed by (HCV Ab by ELISA positive and HCV RNA by
PCR positive) and was divided into 3 groups:
group I : 20 patients chronically infected with HCV received
sofosbuvir(one 400mg tablet taken once daily) & Ribavirin (weight –
related dose ,75 kg or less :400 mg orally in the morning and 600 mg
in the evening ,Greater than 75 g :600 mg orally twice daily and
decrease the dose in case of anaemia ) for 6 months.
group II: 20 Patients chronically infected with HCV received
sofosbuvir(one 400mg tablet taken once daily) & simeprevir( one
150 mg tab taken once daily ) for 3 months.
group III: 20 patients chronically infected with HCV received
sofosbuvir (one 400mg tablet taken once daily with or without food)
& daclatasvir(one 60 mg tab taken once daily ) for 3 months.
In the study, patients achieved high rates of SVR 12(98.3%) only
one patient at group II relapsed after finishing the treatment and did
not reach SVR12.
In the study, there was decrease in fibroscan stages after
treatment with different regmins of DAAs, but it was significant with
group III (HCV patients who received sofosbuvir & daclatasvir for 3
months)
In the study , There is significant improvement in liver enzymes
(AST&ALT) and significant increase at platelet count after treatment
in all the 3 groups, Also there was significant decrease in
hemoglobin level in group I (SOF/RIB) in comparison to other
groups.
Summary
147
In the study, there was no significant change in OV grading in
group I before and after treatment, and also in group II & III only one
patient in each group had changes in OV grading after treatment from
OV grade III to OV grade II.