الفهرس 
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Abstract
Chronic hepatitis C virus infection has been reported in association br with several extrahepatic manifestations, including pulmonary br abnormalities. br This study aimed to: br I. Elucidate the association of chronic HCV infection with some br pulmonary disorders as chronic obstructive pulmonary disease and br bronchial asthma and to determine the relationship between br pulmonary function and severity of hepatic affection. br 2. Elucidate the association of HCV infection with parynchymal lung br involvement and to investigate the relationship of severity of hepatic br affection and respiratory functional and radiological changes. br To achieve these goals this study was carried out on 100 patients br divided into three groups: br Group 1 br Included 40 patients with capo which was further subdivided into 4 br groups: group A: 10 HCV-ve exsmoker, group B:IO HCV-ve current br smokers, group C 10 HCV+ve exsmokers , group 0: 10 HCV+ve current br smokers. br In each patient FEVI and OLCO was measured, reported and br followed up annually for three years. It was found that: br Annual rate of decline of FEVI was significantly higher in group D br (75.7±13.3)mIIy than in group B (58.7±7.2) mIly, C (48.7±4.5) ml/y br which in tum was higher than group A (3l±2.25) mIly . br •:. Annual rate of decline ofDLCO was significantly higher in group D br (4.9±1.7)%/y than group B (3A±OA) %/y, C (3.2±OA) %/y which in br tum was significantly higher than group A (2.6±0.64) %/y . br •:. There was significant negative correlation between base line FEVI br and DLCo and smoking index in current smokers group: B, D. br •:. There was signifant positive correlation between smoking index and br annual rate of decline of FEV1 and DLCO in current smoker groups . br •:. There was no significant correlation between viremia level and AST br and base line FEVI and DLCO. br Group 2 br Thirty patients with bronchial asthma have been divided into two br groups: 15 HCV-ve group, 15 HCV+ve group.the following was done to br these patients: br • Spirometric measurement of Pulmonary function testing using the br same spirometer every six months for three years including flow br volume loop. br • Bronchodilator reversibility testing with salbutamoI, ipratropium br bromide . br •:. There was no significant difference in prebronchodilator FEVI br between HCV-ve and HCV+ve group in the three years of study. br There was signifant difference between postbronchodilator after br salbutamol FEVI between HCV-ve 2.471 ±.499 L and HCV+ve br 2.345 ±.572 L group at the third year of study, And between base br line measures 2.589±.597 L and third year measures 2.345 ±.572 L br in HCV+ve group. br •:. There was significant difference in reversibility after salbutamol br between HCV+ve group 14.7±1.2% and HCV-ve group 22.1±1.8 br % in the third year of study. Moreover reversibility in HCV+ve br group was significantly lower in the third year 14.7±1.2 % than br base line 21.5±2.5% only in HCV+ve group. br •:. There was significant difference in reversibility after ipratropium br bromide between HCV+ve group 7.2±1.7% and HCV-ve group br 4.9±1.3 %in the third year of study. Moreover reversibility in br HCV+ve group was significantly higher in the third year 7.2±1.7% br than base line 5±1.4 % only in HCV+ve group. br •:. There was significant difference in increase in FEVI after br salbutamol between HCV+ve group (299 ± 81 ml) and HCV-ve br group (449±143) ml in the third year of study. Moreover increase br in HCV+ve group was significantly lower in the third year 299 ± br 81 L than base line 459 ± 116L only in HCV+ve group. br •:. There was significant difference in increase in FEVI after br ipratropium bromide between HCV+ve group (149 ± 59 SD) ml br and HCV-ve group (99 ± 31 SD) ml in the third year of study. br Moreover the increase in HCV+ve group was significantly higher br in the third year (149 ± 59 SD) ml than base line (104 ± 27 SD) ml br only in HCV+ve group. br Group 3 br This part of the study was carried out on thirty patients with proven chronic br HCV infection. br In each patient pulmonary function was done to all of them FEvl was br abnormal in 5(16.7%) cases, FVC 6 (20%) cases FEF25-75 was abnormal in br 4 (13.3%) cases. DLCO was performed in 22 cases and was decreased br «80%) in 2 (6.7%). obstructive pattern was present in 1 (3.33%) of cases, br restrictive pattern in 6 (20%) of cases, small airway disease in 4 (13.3%) and br normal ventilatory function in 20 (66.7%) cases. br HRCT was performed to all cases interstitial patterns were detected in br 9 (30%), the total HRCT score was 63, the commonest abnormalities were br ground-glass attenuation in 8 (26.7) cases, with changes other than br interstitial pattern in 8 (26.7%) of cases with normal HRCT in 13 (43.3%) of br cases. br The study showed significant correlation between age and br FEV1IFVC, DLCO and significant correlation between liver biopsy score br and FEv1IFVC. Also there was significant direct correlation between liver br biopsy score and HRCT score. br Otherwise there was no significant correlation between: br _Age and liver biopsy score and FEV1, FVC, FEF25-75. br _Viremia level and liver biopsy score, HRCT score, pulmonary function. br _AST level and pulmonary function and HRCT score. br _Liver biopsy score and FEVl, FVC, FEF25-75, DLCO, HRCT score br _HRCT score and pulmonary function.