الفهرس 
D AIM OF THE WORK ………………...Only 14 pages are availabe for public view
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Abstract
Hepatic fibrosis is the accumulation of extracellular matrix, or scar in response to acute or chronic liver disease. The vast majority of patients with liver disease worldwide have chronic viral hepatitis. One of the leading causes of hepatic fibrosis, cirrhosis and hepatocellular carcinoma is the infection of hepatitis C virus (HCV) which is a major cause of chronic inflammatory liver disease resulting in the destruction of liver parenchyma and its replacement by scar tissue (fibrosis). chronic liver disease progresses through different pathological stages that vary from mild hepatic inflammation without fibrosis to advanced hepatic fibrosis and cirrhosis. A liver biopsy is considered the gold standard for assessment of liver fibrosis. Some patients may don’t want to undergo liver biopsy because of pain and risk of severe complications, so they may not know the stage of their liver disease. So that different histological scoring systems have been developed and modified for quantifying and staging liver fibrosis.
The aim of this study is to assess the diagnostic value of laminin and type IV collagen and their use to discriminate chronic hepatitis c patients with non-significant liver fibrosis (F0-F1) from those with significant liver fibrosis (F2-F4).
The present study included 86 subjects (47 males and 39 females) with age ranged from 26 to 65 years and mean value: 43.097 ± 7.27 years. Subjects were divided into 5 groups:
Controls consist of 20 healthy volunteers, group I (12 patients) infected with HCV showing evidence of liver fibrosis scoring 1 (portalfibrosis without septa), group II (12 patients) infected with HCV showing evidence of liver fibrosis scoring 2 (portal fibrosis with rare septa), group III (30 patients) infected with HCV showing evidence of liver fibrosis scoring 3 (numerous septa without cirrhosis) and group IV (12 patients) infected with HCV showing evidence of liver fibrosis scoring 4 (cirrhosis or advanced scarring of the liver).
Inclusion criteria for subjects included:
• No history of alcohol consumption or drug induced liver disease.
• Seronegativity for viral hepatitis A, B, D or cytomegalovirus infection.
• Negative immunological markers for autoimmune hepatitis.
• Negative markers for intestinal parasites (Bilharzias) infection, Jaundice, Ascites and Oedema of lower limb.
The most important findings of the present study was demonstrated as follow:
• The progression rate of liver fibrosis is increased with HCV-infected males more rapidly than females.
• The degree of fibrosis is increased by increasing the age of the patients. Also the older age at time of infection results in more rapid progression of HCV.
• There is a significant increase in mean levels of AST and ALT in all stages of the studied groups where these levels are more in advanced stages of fibrosis than mild fibrosis stages.