الفهرس 
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Abstract
Hepatitis C virus (HCV) infection is a global health problem. It is the second most common chronic viral infection in the world with a global prevalence of about 3% (170 million people). Egypt has the largest epidemic of hepatitis C virus in the world. The overall prevalence (percentage of people) positive for antibody to HCV was 14.7 % in 2009 to 10.1% in 2016. Rheumatic heart diseases (RHD) constitute 25-40% of all cardiovascular disease in developing countries. It affects 5-30 million children and young adults, with Egyptian prevalence estimated 6.8 per 1000 normal people. Up to our knowledge, the Prevalence of HCV among RHD patients has not reported before. The aim of this study is to determine the Prevalence of hepatitis C marker among patients with rheumatic valvular heart disease. This is a single-center, retrospective study that will review catheterization reports of patients who have been subjected to coronary angiography at Mansoura university hospital, cardiovascular medicine department for 10 years “since September 2006 until August 2016”,where there is a will organized system for keeping all reports that had been done since beginning of work at 14/1/2004 The material of this study comprised a total of 565 reports for patients with RVHD, that comprised 502 angiographic reports before valve surgery and 63 reports of Balloon mitral valvuloplasty (BMV). The results of the Study revealed: Among patients with RVHD, 353 (62.4%) had MVD, 84 (14.9%) had Mitral Regure, 142 (25.9%) had Mitral Stenosis 70 (12.4%) had AVD, 11(1.9%) had AS, 22 (3.9%) had AR, 37(6.5%) had DA and 142 (25.1%) had combined mitral and aortic diseases before DVR (c2 =8.48, P = 0.024). The overall Prevalence of positive HCV serology among patients with RVHD of 21.59%. (27.46% among patients with combined MV and AV diseases (20.96 %) among patients with MV diseases (12.86%) among patients with AV diseases). Significant increase in prevalence of HCV among studied RHD patients prepared for valve surgery in relation to increasing patient age from 0% among patient of less than 30 years up to 33.79% among patient of more than 50 years (c2=38.828, P<0.001). Non-Significant increase in prevalence of HCV among males (23.91%) than females (20%), (c2=3.133, P < 0.05). Significant increase in prevalence of HCV among urban 28.47% than rural 18.34%, (c2=6.38, P = 0.045). Significant decrease in prevalence of Positive Hepatitis C Virus Serology among hypertensive Cases 14.28 % than normotensive Cases 24.36%, (c2 =5.89, P = 0.042). Valuable findings in this study include significant decrease of positive HCV serology prevalence in certain valve lesions with parallel decrease of median age of this lesion group of patients; patients with MS who underwent BMV have the lowest median age (31.09 years) as well as the lowest positive HCV prevalence (7.9%). This could be explained by the younger age of patients suffering from tight MS and seeking treatment by BMV. Conclusion: The Prevalence of HCV among Egyptian patients with severe rheumatic valvular heart disease (21.59%) is more than that reported among general population (10.0% and 14.4%). Prevalence of HCV among Egyptian patients with RVHD increase proportionally with increase of age (from 0% among patients of less than 30 years to 33.79% among patients of more than 50 years).