الفهرس 
HEPATIITIIS C IINFECTIIONOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: HCV, a member of the Flaviviridae family, infects persistently approximately 185 million persons globally. chronic hepatitis C predisposes sufferers to the development of liver cirrhosis, hepatocellular carcinoma, as well as metabolic disorders and cardiovascular diseases. Aim of the work: The aim of this study is to demonstrate the effect of direct acting antiviral drugs (sofosbuvir and daclatasvir) on lipid profile and Apolipoprotien B in chronic hepatitis C patients. The study included two groups with Comparable age, sex and body mass index (BMI). Patients and Methods: This prospective study was carried out in the Gastroenterology and Hepatology clinics at Ain Shams University Hospitals in the period between January 2018 and July 2018. The study was conducted on two groups with comparable age, sex and body mass index (BMI). group 1 include 40 CHC patients receiving sofosbuvir and daclatasvir in dose of 400mg once daily and 60mg once daily respectively for 12 weeks. group 2 40 completely healthy individuals as a control Patients with HBV or HIV, diabetic patient, patient on statin therapy or drinking alcohol are excluded from the study. Results: The study has demonstrated 100% negative PCR for HCV at the end of therapy indicating high efficacy of DAA in treatment of chronic hepatitis c virus patients. We found that Patients in the HCV group had lower total cholesterol levels, LDL cholesterol, HDL cholesterol, triglyceride and apolipoprotien B than the uninfected control group. The study show significant increase in serum triglyceride (p value 0.001) and HDL cholesterol (P value 0.044) immediately after the end treatment. And non-significant increase in total cholesterol and LDL cholesterol after treatment than at base line indicating direct effect of HCV clearance on host lipid metabolism. The study also demonstrate significant increase in serum Apolipoprotien B (p value <0.001) with the end of treatment. These findings suggest that HCV infection by itself may be involved in the disturbance of serum lipoproteins/ apolipoproteins Therefore, examining serum lipoproteins/apolipoproteins is beneficial for monitoring disturbed lipid metabolism induced by HCV. Conclusion: The sofosbuvir/daclatasvir -based therapy continues to show a high degree of effectiveness in the treatment of CHC GT4. High efficacy of these drugs ameliorates the predictive effect of metabolic factors. The lipid changes in this study were interesting, in our study, the changes in lipid profile after DAAs were atherogenic, which might represent a predictor for cardiovascular risk. This may justify long-term monitoring of lipid parameters.