الفهرس 
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Abstract
Background: Egypt has the highest prevalence of HCV estimated at 10% with HCV genotype 4 accounting for more than 90% of infections.The standard treatment of chronic hepatitis C had been a combination of pegylated interferon and ribavirin for many years, but this combination had many drawbacks. The management of HCV entered a new era after the advent of direct acting antiviral agents. The aim of the work: This study aimed to investigate the impact of sofosbuvir/ daclatasvir combination therapy of DAAS on the immune status of chronically infected hepatitis c patients. Materials and Methods: Twenty-two patients were gathered, of them only fifteen patients completed the study and the remaining patients dropped out. All patients underwent full history taking, full clinical examination and routine laboratory investigations including: HCV RNA, liver function tests, serum creatinine, CBC, INR, AFP, TSH, FBG, HBs Ag, ANA, antibilharzial antibodies, pregnancy test, imaging studies as abdominal ultrasound, ECG, FIB4 and immunological markers testing (CD3, CD4, CD8, CD4/CD8 ratio and CD56). Patients were treated with sofosbuvir plus daclatasvir for 12 weeks.Patients were followed biologically for negative HCV RNA PCR after therapy, biochemically and hematologically by liver function tests (ALT, AST, serum albumin, total bilirubin), serum creatinine, CBC and INR every month and at the end of therapy and immunologically by total T (CD3⁺) cells, T helper (CD3⁺CD4⁺) cells, T cytotoxic (CD3⁺CD8⁺) cells, CD4/CD8 ratio and natural killer (CD56⁺) cells at the end of therapy.