الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) infection is of a significant global impact and a major leading cause of mortality and morbidity . chronic HCV infection not only affects the liver, but can involve many other organs and systems. Several extra-hepatic diseases, including dermatologic, hematologic, autoimmune and metabolic disorders have been associated with chronic HCV infection HCV has many extra-hepatic manifestations as insulin resistance (IR) And DM. whether development of IR among patients with chronic HCV is independent of other metabolic and socio-demographic factors is still debatable. A lot of studies had been done to estimate relationship between HCV infection, eradication and insulin resistance with conflicting results. So, this study was designed. The aim of this work is to study the effect of HCV eradication on insulin resistance by using DAAs. This is a prospective cohort study carried out from September 2016 to February 2019 at Gastroentrology and Hepatology Unit, Specialized Medical Hospital, Mansoura University, Egypt. The study included 150 patients with chronic HCV infection who are eligible for treatment by DAAs and not diabetic. 10 patients were on the waiting list for treatment and considered as control group, 24 patients started treatment and later on they were excluded from study either due to non compliance to treatment (22 patients) or deterioration of patient condition that necessitate to stop of treatment. The remaining 116 patients completed treatment course in the form of sofosbuvir plus daclatasiver with or without ribavirin according to guidelines provided by the Egyptian National HCV Control Program, were further divided according to response to treatment into responder group includes 106 patients( 91.3% of the patient group) and non responder group includes 10 patients (8.7% of patient group). The results of the present study found significant reduction in HOMA-IR, FBG and fasting insulin level in patients who achieved SVR in comparison to control and non-responder groups, inspite non significant difference between the three groups regarding socio-demographic data and BMI. In conclusion, HCV eradication by new DAAs improves insulin resistance in chronic hepatitis C patients as manifested by significant reduction of HOMA-IR which occur through significant lowering of both FBG and F INS levels.