الفهرس 
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Abstract
The purpose of our study was to examine the glycemic control
effect on the response to the new therapy of HCV and the essence of the
new therapy of HCV on HbA1c level in patients infected with HCV
genotype 4.
In our study the target population included HCV patients who had
been receiving new treatment for HCV in between March 2016 and
September 2016 (6 months) from age 18 years to 75 years.
In this study HbA1C have been evaluated in 359 HCV patients.
The study was approved by Health Research Ethics Committee,
and a patient’s consent was taken.
These members will be subdivided into 3 groups.
group 1 includes 126 non-diabetic patients with HCV positive
infection. group 2 was 118 T2DM patients with controlled HbA1c
(less than 7%). And group 3 includes 115 T2DM patients on
treatment with uncontrolled HbA1c (> or = 7%).
Exclusion criteria:
Current pregnancy or breast feeding, Hepatic patients with total
bilirubin > 3mg/dl, serum Albumin <or=2.5 mg/dl, INR> or=1.8,
platelets < 50000, child score >class B7. And those have HCC.
All those groups had been receiving the new therapy of HCV in
the form of sofosbuvir plus daclatasvir with or without ribavirin and we
measured the HbA1c level just before the beginning of the new therapy to
HCV, after 3 months of therapy and after 3 months from the end of
treatment, and we compared the response to this new therapy according to
the level of HbA1c by quantitative PCR after the end of treatment. We
utilized stanbio glycohaemoglobin procedure No.0350 (Quantitative
colorimetric determination of glycohaemoglobin in whole blood) for HbA1C measuring.
All patients had been subjected to the following:
Thorough history taking.
Laboratory investigations, including:
Random blood sugar, ALT, AST, INR, prothrombin time, serum
creatinine, complete blood picture, Alfa feto protein, HCV antibody, HCV
quantitative PCR, abdominal U/S and TSH.
Our study shows that in controlled diabetic group: there is a highly
significant decline in HbA1C level after 6 months from start of treatment
than pre-therapy & after 3 months. And highly significant decline of
HbA1C level after 6 months than after 3 months from start of treatment.
In uncontrolled diabetic group: there is a highly significant decline
in HbA1C level after 3 and 6 months than pre-therapy. And, highly
significant decline of HbA1C level after 6 months than after 3 months
from the start of treatment.
Considering the effect of DAAs therapy on HbA1C in non-diabetic
group, there is high significant rise after 3 months than pre-therapy. While
there is a significant decline of HbA1C in non-diabetic group after 6
months compared to 3 months from start of treatment. Simply there is no
significant difference of HbA1C between pre-therapy and 6 months from
start of discussion.
Regarding thyroid function tests, we found that there is a highly
significant decline in TSH level in non-diabetic group and controlled
diabetic group after 3 and 6 months from the start of treatment than pretherapy.
And, there is a highly significant decline of TSH after 6 months
than 3 months from start of treatment In uncontrolled diabetic group; there is a highly significant decline
in TSH level with HCV treatment after 3 and 6 months than pre-therapy.
While no significant difference after 6 months compared to 3 months
from start of treatment. This shows that new DAAs interferon free
therapy has a beneficial effect on TFTs.
Regarding the PCR level in the 3 studied groups, we found that
there is a highly significant decline of PCR to at EOT and with SVR12
compared to pre-therapy. While there is no significant difference in the 3
studied groups at end of treatment compared to SVR12.