الفهرس 
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Abstract
Hepatitis C virus infection is a major health issue worldwide. The World Health Organization estimates globally, about 58 million people have chronic HCV infection, with about 1.5 million new infections occurring per year. Besides liver sequelae such as end‐stage liver disease and HCC, chronic infection has been associated with multiple extra‐hepatic manifestations which lead to increased morbidity and all‐cause mortality rates Also, patients with HCV infection are vulnerable to many metabolic complications. These include diabetes mellitus and insulin resistance. Metabolic comorbidities negatively affect patients’ prognosis because of their independent association with progression of hepatic fibrosis and HCC development. Furthermore, they also contribute to the increase in cardiovascular risk The current study was conducted at Assiut University Hospitals. It aimed to assess changes in liver fibrosis and stiffness, lipid profile and insulin resistance in patients with chronic hepatitis C viral infection who received direct acting antiviral therapy The study enrolled 80 patients with chronic HCV infection and subdivided into equal groups either with liver cirrhosis or without. LC group received Sofosbuvir and Daclatasvir and weight based ribavirin for 12 weeks while non-LC group received Sofosbuvir and Daclatasvir for the same duration according to the recommendations of The Egyptian National Committee for Control of Viral HepatitisAll participants were subjected to through history evaluation and complete physical evaluation. Baseline laboratory data in addition to insulin resistance and lipid profile were done. Degree of fibrosis was assessed as baseline LSM by fibroscan. Those patients were followed up to three months post-therapy It was found that all patients achieved SVR. Also, majority of them developed no adverse events during course of therapy Degree of liver fibrosis was markedly decreased in all study patients during follow up period as assessed by different markers of fibrosis including LSM by fibroscan and non-invasive biomarkers as FIB-4 index and APRI score.