الفهرس 
HEPATITIS C VIRUSOnly 14 pages are availabe for public view
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Abstract
The high incidence of hepatitis C virus (HCV) makes it one of the greatest health threats facing the world .The prevalence of HCV infection in Egypt is the highest reported world-wide . about 85% of those infected with HCV will develop chronic hepatitis of varying severity. Nearly 20 % of patients develop cirrhosis in 10 - 20 years and the incidence of hepato-cellular carcinoma (HCC) is 1 – 4% per year in patients with cirrhosis . Hepatitis C is a treatable disease, and over the last few years increasing numbers of patients have been offered antiviral treatment to eradicate the virus. However, treatment is cytotoxic and associated with a multitude of adverse side effects .The treatment for HCV involves a combination of two drugs: Pegylated Interferon (a subcutaneous injection that is given once weekly) and ribavirin tablets that are taken orally each day for one year . adherence of patients to therapy is important because it can slow down the disease process. Side effects of antiviral therapy include nausea, pain and depression, which can also have a serious impact on the ability to work and on quality of life . Side effects such as worsening fatigue, insomnia, alopecia and arthralgia are common.
This retrospective observational study included 200 medical files of adult HCV patients who received antiviral therapy and completed treatment for one year. The medical files were revised from 2010 at the outpatient clinic in EL-Kabbary hospital and the first 200 files that were found with complete data were included in the study
Inclusion criteria: (Adopted by National Program for Control of HCV at that time )
- chronic HCV infection patients proved by positive HCV antibody by ELISA and Positive serum HCV-RNA by PCR.
- Persistent elevation of ALT and AST levels for at least 6 months.
-All patients received combination therapy Pegylated Interferon and ribavirin for48weeks. Two PEG-IFN alfa preparations are available:
(1)PEG-IFN alfa-2b, administered as weight-based, 1.5μg/kg dose.
(2) PEG IFN alfa-2a, administered at a fixed, 180μg dose.
Ribavirin dose : <75 kg -1200 mg/day.
>75 kg -1000 mg/day.
Medical records from patients sheets were checked and the All the files were revised and all adverse effects were recorded. Fifteen patients developed significant weight reduction (loss 10 % of his pre treatment weight) 7.5 % . Regarding temporary stoppage of treatment sixty seven Patients 33.5% were stopped treatment due to respiratory complications and hematological complication mainly anemia and thrombocytopenia . Regarding temporary dose reduction thirty seven 33.5 % were reduced treatment due to respiratory complications and hematological complication mainly anemia and thrombocytopenia
This study showed that Flu-like symptoms usually occurred during the first weeks of treatment and severity declined over time..gastrointestinal ADRs included nausea, anorexia, vomiting and dyspepsia. They showed a uniform pattern of increase followed by a decrease . cutaneous ADRs were reported early and decreased with the end of treatment. They were mainly injection site reactions, skin rash and itching. neuropsychiatric ADRs were reported and they were mainly lack of concentration, insomnia, and depression. weight loss, from week 2 to week 40 number of patients increased and reached highest level in week 16. week 24 Depression reached highest level 22%.