الفهرس 
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Abstract
Hepatitis C is an infectious disease affecting the liver, caused by HCV. The
infection is often asymptomatic, but once established, chronic infection can progress to
scarring of the liver (fibrosis), and advanced scarring (cirrhosis) which is generally
apparent after many years. In some cases, those with cirrhosis will go on to develop liver
failure or other complications of cirrhosis, including liver cancer (Fan et al., 2019).
In clinical practice, diagnosis of HCV infection is usually based on the detection of
anti-HCV antibodies in the serum. However, most assays cannot distinguish infected
individuals with an ongoing active infection from those who have recovered from acute
infection (National Institutes of Health. 2002).
The HCV core antigen (HCVcAg) is a recently developed marker of HCV
infection. It exists in both complete virions and RNA-free core protein structures and has
been detected in the serum of infected individuals. Several HCVcAg assays developed in
the last decade have been shown to have good correlation with HCV RNA assays. Hence,
these assays were used as an alternative to HCV RNA for the diagnosis of active HCV
infection as well as for the monitoring of the response to antiviral therapy (Nguyen et al.,
2016).
During the last decade, intensive efforts focused on the development of direct
acting antiviral agents (DAAs) that block the activity of viral enzymes regulating HCV
poly-protein processing or HCV replication. Throughout 2016, the remarkable success of
DAAs was confirmed and extended. Several new drugs were approved, representing
continued remarkable potency of the DAA agents with the added bonus of extension into
more pangenotypic activity
The aim of this study was to correlate between serum levels of HCVcAg and HCV
RNA assay and to evaluate the performance of the HCVcAg assay in predicting treatment
response to direct acting antiviral drugs (Kim et al., 2016).
This study was carried out on 28 CHC patients, 18 males and 10 females, admitted
to Shebin El-Kom Fever Hospital and all were treated by the newly DAAs for 3
months .We measured the levels of HCVcAg by ELISA and HCV RNA by Real time
polymerase chain reaction (RT-PCR) three times; the first was before beginning of
treatment, the second was at the end of treatment and the third was three months after
treatment cessation.
According to HCV viral load, group I: Comprised 14 patients (10 males and 4
females) with mild viremia, their ages ranged from 21 to 58 years old with a mean age of
39.1±11.8 years. group II: Comprised 8 patients (5 males and 3 females) with moderate
viremia, their ages ranged from 20 to 75 years old with a mean age of 40.4±15.6 years.
group III: Comprised 6 patients (3 males and 3 females) with severe viremia, their ages
ranged from 26 to 62 years old with a mean age of 40.0±15.2 years.
The patients were subjected to complete clinical examination and history taking,
assessment of severity of liver affection according to Child–Pugh score, routine laboratory
investigations including; Complete blood count (CBC), kidney function tests (serum urea
& creatinine) and blood glucose and specific laboratory investigations including; Liver
function tests {serum total bilirubin (TBIL), albumin (ALB), alanine aminotransferase
(ALT), aspartate aminotransferase (AST), gamma-transferase (GGT), alkaline phosphatase
(ALP), alpha fetoprotein (AFP), International Normalized Ratio (INR) and prothrombin
time (PT) & concentration (PTC)}.