الفهرس 
Hepatitis COnly 14 pages are availabe for public view
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Abstract
Background: Hepatitis C virus infection (HCV) is a well-known cause of many rheumatic diseases, most notably HCV-related cryoglobulinemic vasculitis, fibromyalgia, arthralgia and Sicca Syndrome. Interferon-free regimens that combine novel direct-acting antivirals Direct acting antivirals are highly effective for the treatment of chronic Hepatitis C virus infection.
Aim of the Work: The aim of this study is to evaluate the clinical and serological course of HCV related rheumatic manifestations in a cohort of Egyptian patients with chronic hepatitis C before and after treatment with new direct-acting antivirals.
Patients and Methods: This study was carried out on 60 Egyptian patients with chronic hepatitis C suffering clinically from one or more of the HCV- related rheumatic manifestations and eligible for treatment with sofosbuvir (400 mg daily) plus daclatasvir (60 mg daily) as a direct-acting antivirals for 3 months. All patients signed a written informed consent prior to enrollment into this study. This study was approved by the Ethical Committee of Ain Shams University College of medicine.
Results: Our results showed that among the 60 patients, 21 patients (35.0%) met the criteria of Mixed cryoglobulinemia syndrome, 19 patients (31.7%) were complaining of Arthralgia, 17 patients (28.3%) were complaining of Fibromyalgia and 3 patients (5.0%) were complaining of Purpura without other criteria of Mixed cryoglobulinemia syndrome. Complete clinical response was achieved in a significant number of patients with MCS, also with significant clinical improvement in patients with fibromyalgia, arthralgia and purpura. Regarding the immunologic response to DAAs, significant reduction but not complete normalization in auto-antibodies at short term follow up was observed
Conclusion: Sustained virologic response correlates with clinical and immunological improvement in most patients with HCV related rheumatic manifestations among the studied group of Egyptian population.
Recommendations: Longer follow-up period after viral eradication might be necessary for Egyptian patients with hepatitis C virus related rheumatic manifestations after completion of sofosbuvir based therapy to assess long term efficacy of these regimens in achieving and maintaining clinical and immunologic response.