الفهرس 
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Abstract
The World Health Organization (WHO) estimates that 3% of the world’s
populations, approximately 170 million people are infected with HCV.
Approximately 60% of persons with HCV infection develop chronic or lifelong
infection with HCV (WHO; 2011).
Epidemiologic studies suggest that HCV continues to be transmitted at relatively high rates. Monitoring the incidence of HCV infections is difficult because most infections are asymptomatic, and available assays do not distinguish acute from chronic or resolved infections, also the epidemiology of HCV transmission in Egypt has been the subject of intense study in the last two decades since HCV diagnostic assays became available. Several studies have documented a prevalence of HCV antibodies ranging from 6 to 20% in the general Egyptian population. Based on these studies, it is projected that 248,000 to 416,000 infections may occur each year in
Egypt (El-Zanaty and Ann; 2008).
Vitamin D, identified in 1919 as an anti-rachitic agent (Morris; 2005). The
biologically active form of vitamin D, 1, 25 hydroxy vitamin D (1, 25(OH) D),
modulates the adaptative immune system by direct effects on T and B cells
proliferation and dendritic cells (DCs) maturation. Molecular actions of vitamin D lead to a shift from T helper(Th)1 to Th2 phenotype as well as to the development of DCs with tolerogenic properties, thus vitamin D exhibits an immunosupresor effect promoting self-tolerance and limits the inflammation (Petta et al; 2010).
People with liver disorders frequently develop vitamin D deficiencies such as
hepatic osteodystrophy, a multifactorial disease, on the other hand, the impact of serum levels of vitamin D on the outcome of liver diseases is unclear liver, recent
studies suggested wider correlations regarding the plasma level of vitamin D or genetic polymorphisms of VDR with hepatobilliary diseases including the viral hepatitis B or C (Petta et al; 2010). Moreover, an association between baseline vitamin D status and treatment response to pegylated-interferon (PEG-IFN) and ribavirin (RBV) has recently been established (Martin et al; 2010).
The title of this study is ” Relation of vitamin D serum level to severity of fibrosis and response to interferon-based therapy in chronic hepatitis C (HCV) patients ” The aim of the study, to clarify if there is a relationship between the serum vitamin D level and the severity of fibrosis and the degree of response to interferon -based
therapy in the center for treatment of chronic hepatitis C in Ismailia.
The study was carried on 89 patients with chronic hepatitis C who were attending to the center for treatment of chronic hepatitis C in Ismailia fever hospital and were eligible for treatment with pegylated Interferon and Ribavirin.
The patients were followed up for a period of 12 weeks from the start of the
therapy to determine the relation between vitamin D level and degree of response to the treatment.
In this study:
-The mean age of patients was 41.8 years (52.8% were males), about 2\3 of them were from rural areas and the majority of were married (92.1%) and non smoker (90%).
-Most frequent risk factors for HCV infection in our study population were dental procedures 74%, previous treatment of schistosomiasis by tarter emetics 50%, surgical procedures 49% and transfamilial infection of HCV 32%.
-There was statistically significant decrease of Hb, TLC, PLTs and liver enzymes after 12 weeks of treatment.
-About 42 % of our patients were suffering from mild to moderate vitamin D deficiency.
-Patients with mild/moderate vitamin D3 deficiency were statistically significant non-responder than patients with normal vitamin D3 levels. There was statistically significant relationship between the serum vitamin D level and the degree of response
to treatment.
-There was no statistically significant relationship between the serum vitamin D level and the severity of liver fibrosis.