الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Chronic Hepatitis C is a viral illness that affects the liver. HCV is an enveloped flavivirus with a 9.6 kb single-stranded RNA genome. Egypt has a high prevalence of HCV especially genotype 4a. In addition; HCV infection is a major cause of progressive liver disease and the leading indication for liver transplantation worldwide. Hepatitis C virus (HCV) is one of the major causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma, although the exact mechanism of hepatocellular damage in chronic HCV infection remains unclear. Currently, the standard pharmacological treatment for HCV infection is IFN-α in combination with ribavirin. Unfortunately, more than 50% of patients with chronic HCV infection either not respond (Non-responders) or relapse when therapy is stopped (Relapsers). The PEG-interferon and ribavirin combination significantly reduces the rate of fibrosis progression in patients with hepatitis C. In Egypt, HA is considered one of the simple biomarkers that can assist the clinician in making prognostic and therapeutic decisions. Moreover, hepatitis C virus has the capacity to generate substantial oxidative stress within hepatocytes. And so, oxidative stress was a significant mechanistic pathway culminating in the development of hepatic cirrhosis, liver failure and liver cancer but the effect of INF treatment on that oxidative stress are not clear. Therefore, this study was designed to study the effect of PEG-INFα-2b plus ribavirin treatment on the liver status and degree of fibrosis of the hepatitis C patients especially those who non-respond and relapse after treatment. These fibrosis markers such as hyaluronic acid and its degraded enzymes were evaluated. The effect of therapy on oxidative stress such as total antioxidant activity (TAO) as antioxidant biomarker and nitric oxide (NO) as oxidant biomarker were also studied. In addition, serum ferritin level before, during and after the end of treatment and its relation to the INF response was also done. In addition, MDA as a reflector of lipid peroxidation was also done. As well as, gamma-glutamyl transferase and routine liver function tests were also done to these patients and to the healthy control group. Serum ferritin level was elevated in pretreatment patients who didn’t respond to INF treatment than those who respond to therapy. During the follow-up study this parameters level was not increased in responders and increased gradually in non-responders groups. Hyaluronic acid (HA) as a marker of fibrosis decreased in the end of treatment as well as in the breakthrough after 48 weeks. SVR group and relapsers also decreased until reaches the control level and this approves the anti-fibrotic effect of INF treatment. Also, the high ferritin level in pretreatment patients may cause non-response to therapy. These findings triggered us to hypothesize the possible use of the serum ferritin as an independent predictor of virological response in Egypt HCV infected patients. Also, this study demonstrate that treatment with interferon reduces the oxidative stress on the hepatocytes that was due to HCV infection by stopping the viral activity, improve the general condition of the liver cells and reduces the risk of liver fibrosis.