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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). |