الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
Background: Hepatic steatosis in hepatitis C virus (HCV) infected patients has been shown to enhance the progression of liver fibrosis and cirrhosis. Liver biopsy was the gold standard for diagnosis of hepatic steatosis. However, liver biopsy is an invasive procedure and associated with complication (e.g., bleeding). Recently, controlled attenuation parameter (CAP) in transient elastography (TE) has been introduced to detect and quantify hepatic steatosis. CAP measures the ultrasonic attenuation in the liver tissue depending on the viscosity [fat] of the medium [liver] and the distance of propagation of the ultrasonic signals into the liver. Non alcoholic fatty liver disease (NAFLD) was defined by CAP values ≥ 216 dB/m. Direct-acting antiviral (DAA) therapy is associated with high sustained virologic response (SVR) and overcomes negative predictive factors including steatosis.
Objectives: The aim of this study to use the fibroscan as non invasive modality for study the impact of hepatic steatosis on SVR in HCV infected patients receiving DAA therapy.
Results: This study was conducted on 40 patients diagnosed as HCV with NAFLD based on positive anti-HCV antibody, positive HCV viremia, abdominal ultrasonography, serum liver enzymes, body mass index (BMI). All patients assessed by TE with CAP to detect and quantify hepatic steatosis (CAP cut off value ≥ 216 dB/m) and also assessed by non invasive scores (APRI score, FIB-4 score, HSI score). After start of antiviral treatment, patients were seen every 4 weeks until the end of therapy and 12 weeks after the end of therapy to assess SVR-12. The overall SVR-12 (n=36) was 90% and was not impacted by presence of hepatic steatosis.
Conclusion: Our study confirmed that hepatic steatosis has no impact on SVR in HCV infected patients receiving DAA therapy. TE with CAP can be used as non invasive method for assessment of hepatic steatosis