الفهرس | Only 14 pages are availabe for public view |
Abstract Egypt has the largest burden of HCV infection in the world, with a 10 % prevalence of chronic HCV infection among persons aged 15-59 years (El-Zanaty and way., 2008). Metabolic bone disease is a significant disorder which appears in patients with chronic hepatopathy (also known as HO), especially in those affected by chronic cholestasis. Its etiology is complex and multifactorial and manifest as osteopenia and osteoprosis. This bone disorder must be evaluated and detected early in all patients with chronic liver disease in order to minimize the risk of fractures and improve their clinical progression and quality of life (Sanchez etal., 2006). All currently available therapies for treatment of chronic HCV are based on the activity of group of biological agents called alpha interferon (Keam and Cvetikovic., 2008). The estimated cost of care and treatment program for the Egyptian government is $80 million annually, which covers 40% of total costs of the program; the remaining 60% is paid by insurance companies and patients (Ford etal., 2012). INF has been shown to be effective in inducing inhibition of viral replication, normalization of liver tests and even improvement of liver histology in HCV-related liver diseases and it is known that INF-α may affect bone turnover. There is limited information about the long term effect of INF-α therapy on bone metabolism (Lee and Karsety., 2009). Osteocalcin is the most abundant non collagenous protein of bone matrix (Razzaque., 2011). It is a product of differentiated osteoblast. |