الفهرس 
Hepatitis C virusOnly 14 pages are availabe for public view
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Abstract
Chronic hepatitis C virus (HCV) infection is a major global health problem affecting over 185 million people worldwide. It is characterized by inflammatory liver damage, and is associated with a high risk of development of cirrhosis and hepatocellular carcinoma.
The Demographic Health Survey (DHS) of 2015 included the age groups 1–59 years. The seroprevalence in the age groups 15–59 years was 10% (compared to 14.7% in the 2008 DHS), and the prevalence in the group aged <15 years was 0.4%, which brought the total seroprevalence in those aged < 60 years to 6.3% and the viremic prevalence to 4.4% (7% in the age groups 15–59 years and 0.2% in those aged <15 years).
Hepatitis C infection is characterized by high rates of chronicity as 70-85% of acute HCV cases evolve into chronic hepatitis. Approximately 20% of chronically infected patients develop liver fibrosis and cirrhosis with subsequent progression to end stage liver disease or hepatocellular carcinoma.
Fibrosis is a non-specific response to injuries which implies the synthesis of an extra-cellular matrix (ECM). In fibrotic liver there are quantitative and qualitative ECM changes and the progression of fibrosis leads to cirrhosis.
Histological examination of the liver is an integral part of the evaluation of patients with CHC. Knowledge of the stage of liver fibrosis is essential for prognosis and decisions on antiviral therapy.
Liver biopsy remains the gold standard method in the diagnosis and staging of liver fibrosis. Although liver biopsy in general is a safe procedure, it is costly and does carry a small risk for complication, in addition there could be sampling error, inter- and intra-observer discrepancies in assessing hepatic fibrosis. Hence, there is a need to develop accurate and reliable non-invasive means to assess the severity of hepatic fibrosis.
This study aimed to assess the diagnostic accuracies of four laboratory scores (FIB-4 score, APRI score, LOK score and platelets count) in comparison to each other and to liver biopsy.
This study was conducted on 500 patients suffering from chronic HCV infection with or without cirrhosis (as proved by biopsy). They were randomly selected from those attending to the outpatient clinics of Shebeen El kom teaching hospital., they were of both sexes (356 males (71.2%) and 144 females (28.8%)) and their ages ranged from18 to 59 years (mean 40.534± 9.020), 71.2% of the studied group were complaining of fatigue, 28.8% have bleeding tendency, 15 % lower limb edema and by examination there was 32% of patients had hepatomegaly and 28% had splenomegaly.
Chronic HCV infection was confirmed by detectable HCV-Ab by ELISA ≥ 6 months and serum HCV-RNA positivity by PCR.
It was found that, there was statistical correlations between demographic data and laboratory investigations of studied population according to degree of fibrosis in liver biopsy shows significant correlation regarding ( age, albumin, AST, ALT, total bilirubin, INR, PT% and platelet count) and no significant correlation regarding (gender, creatinine, WBC, HB, HCV- RNA).