الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
HCV virus infection is an important cause of chronic liver disease in Egypt and leads to progressive fibrosis, cirrhosis and finally HCC and liver failure. In recent years, DAAs replaced IFN therapy as the main line of treatment with a higher rate of patients achieving SVR which may reach over 90% and fewer side effects, however liver fibrosis still unresolved issue. Regression of fibrosis has been an important topic for research for years and data with IFN-based treatment reported liver fibrosis regression after SVR, however few recent studies that evaluate liver fibrosis regression with DAAs. Since fibrosis stage and/or liver stiffness are associated with adverse outcomes such as HCC, the correct and serial evaluation of liver fibrosis is necessary to help planning of post SVR management and assess the regression of liver fibrosis and cirrhosis.
Liver biopsy has remained the gold standard for accurate assessment of liver fibrosis either pretreatment or after SVR to antiviral therapy, however being an invasive procedure with several complication makes its use in clinical practice for serial assessment of the patients in applicable especially with presence of a safe non-invasive methods as FIB-4 and APRI scores which can evaluate liver fibrosis in CHC. ARFI elastography is a novel non-invasive technique incorporated in the ultrasound machine and able to predict fibrosis stage in CHC patients. Several studies has used Fibroscan,a similar technique to ARFI, for evaluation of fibrosis regression either with IFN-based or DAAs-based treatment. However, there are few studies which investigate serial changes in LSMs by ARFI in patients received DAAs for HCV infection. Therefore, the current study designed to evaluate the dynamic changes in LSMs by ARFI elastography as well as serum-based fibrosis scores (FIB-4 and APRI) in CHC patients who achieved SVR after DAAs-based therapy and to assess the factor associated with these changes.
To achieve this goal, 52 treatment-naïve patients with CHC who continued follow up till SVR 24 were included in the study. They were 33 males and 19 females and their ages ranged between 21 and 72 years (mean SD = 49.92 ± 12.1 years). The diagnosis of CHC was based on the following criteria: (1) positive test for HCV antibody, (2) detectable serum HCV RNA and the diagnosis ofliver cirrhosis was basedon a clinical basis, laboratory tests and ultrasonographic findings of liver cirrhosis and/or ARFI measurement ≥1.8 m/s.