الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
LC is a final pathway for a several chronic liver diseases and is defined as the histological formation of nodules regenerative and fibrous bands surrounding them in response to continuous exposure to liver injury.
One of the most common leading causes is chronic infection with HCV with Egypt having the largest prevalence of HCV infection worldwide. However, HCV epidemiology differed rapidly after a scale up in screening and prevention measures and achieving high cure rates in the era of using DAAs therapy. Egypt embarked on an aggressive screening and treatment program that resulted in HCV elimination as a public health threat in 2023.
PH is one of the most important sequelae of LC which causes the majority of its complications like EV, ascites and splenomegaly.
Collateral circulation is developed as adaptive response when the portal circulation is obstructed in order to divert portal blood again into the systemic veins, which leads to development of esophageal varices which are the most important collaterals.
VH is one of the most severe and immediately deadly complication in patients with LC with six-week mortality rates ranging between 12% and 22% after an attack of bleeding. Screening for these varices before bleeding is essential.
EGD remains the gold standard for diagnosis and management of varices and current guidelines recommend screening cirrhotic patients by an EGD to detect EV in early stages, and to institute prophylactic measures in patients with large EV. However, EGD is an invasive and expensive procedure with associated risks which necessitate searching for newer simple non-invasive markers with high sensitivity and specificity for prediction of varices which might decrease the frequency of performing EGD.
Interleukins (ILs) are a group of cytokines which create a stimulus for immune responses such as inflam