الفهرس 
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Abstract
The highest prevalence of HCV was reported in Egypt, where
genotype 4 is responsible for 91% of infections (Wantuck et al., 2014)
and DAAs represented the main line of treatment in most centers (El
Kassas et al., 2016). Although, the changes in lipid metabolism after
treatment with DAAs were reported for other genotypes (Gitto et al.,
2017), it was not studied in genotype 4 infected patients.
This prospective case control study was conducted on100 patients
(56 males and 44 females; their ages ranged from 21–59 years with mean
(40.07±9.54 y) with HCV positive candidates for therapy with
DACL+SOF±RBV selected from Shebin El Kome fever hospital in
addition, 20 healthy, age- and sex-matched participants were involved in
this study as control group (9 males and 11 females; their ages ranged
from 21-48 years with mean (37.70±11.49) in the period between
February 2017 to August 2017 aimed to study lipid profile in HCV
patients before and after treatment to determine the effect of virus
clearance on lipid level in blood.
The studied participants were divided into 2 groups:
group (1): 100 patients with HCV infection who did not receive
treatment before (Naive patients).
group (2): 20 healthy volunteers of comparable age and sex as control
group.
Patients with the following criteria were excluded, because this
potentially affects the results: Patients with (hepatitis other than HCV,
immunodeficiency virus, recipients of organ transplants, DM,
hypertension and heart diseases, obesity, receive any treatment affect severity was assessed by using the Child-Pugh score.
All patients and healthy individuals were subjected to the following:
1- Proper and detailed history taking
2- Full clinical examination including: General examination and
local examination of the abdomen.
3- BMI.
4- Fib-4: calculated by this equation (Age x AST)/(Platelets x
sqr(ALT).
5- Routine laboratory investigations:
CBC.
Liver and kidney function tests.
6- Lipid profile: Total cholesterol, triglycerides, high-density
lipoprotein and low-density lipoprotein.
7- PCR for HCV.
8- Radiological investigations: Abdominal ultrasonography.
9- ECG.
Measured before treatment, after 3 months and after 6 months
from the start of treatment
The results of this study were:
There was highly significant statistical difference as regards (serum
LDL-C, cholesterol and triglycerides) between patients and
controls while, no statistical significant difference in HDL-C in
both groups.
There was no significant statistical difference as regard LDL-C,
HDL-C, cholesterol and triglycerides in child A or B of the studied
patients.
There was highly significant statistical difference before and after
treatment in studied patients as regard ALT and AST (P value=
0.0001) and statistical significant difference in FIB-4 (P value=
0.01).
There was highly significant statistical difference before and after
treatment (DCV+SOF±RBV) in studied patients as regard HCV
PCR viral load (P value= 0.0001).
There was significant statistical difference as regard (LDL-C,
HDL-C and cholesterol ) at the end of treatment and 12 weeks after
treatment when compared to its level before treatment (P < 0.05)
and (0.01) respectively and highly significant changes in
triglycerides level (P value = 0.0001).
There was highly significant statistical difference as regard (LDLC
, HDL-C and cholesterol) at the end of treatment and 12 weeks
after treatment when compared to its level before treatment (P
value= 0.0001) and statistical significant difference in triglycerides
level (P value= 0.01).
There was highly statistical significant effect of LDL-C and
cholesterol pretreatment levels on the Δ LDL-C (p value= 0.0001)
and significant effect of total leucocytic count (p value < 0.05).
There was no statistical significant role of the type of therapy on
the Δ LDL-C.
There was statistical significant effect of LDL-C level on the Δ
LDL-C (OR (95% C.I.) 1.096(1.023-1.175) and (P value = 0.01) and significant effect of BMI and triglycerides level (OR (95% C.I)
(0.784 (0.637-0.964) and (1.032 (1.005-1.060) respectively and (P
value< 0.05).
There was highly statistical significant effect of LDL-C and
cholesterol levels on the Δ cholesterol (P value= 0.0001) and
significant effect of BMI and total leucocytic count (P value=
0.01). There was no statistical significant role of the type of
therapy on the Δ cholesterol.
There was statistical significant effect of cholesterol and
triglycerides level on the Δ cholesterol OR (95% C.I.)
(1.054(1.003-1.108) and (0.956(0.915-0.998) respectively (P-value
< 0.05).