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. The aim of this study was to evaluate the usefulness of peripheral CXCL10 levels as noninvasive biomarkers of hepatic fibrosis and a predictive marker for treatment outcome in patients with chronic HCV infection. This study was carried out on 84CHC patients, 66 males and 18 females, attended to the national liver institute, Menoufiya University for receiving INF therapy. The degree of liver fibrosis was assessed by fibroscan. Patients were followed up for 18 months to assess their response to INF therapy. HCV RNA levels were quantified at baseline and at weeks 4, 12, 24 during treatment and 24 weeks after stopping therapy for determining RVR, EVR, non-responding at week 24 and SVR.CBC, liver function tests and pretreatment serum CXCL10 by ELISA were measured. The study results revealed that: Pretreatment serum CXCL10 levels differed significantly among patients with different stages of fibrosis with higher levels in the advanced fibrosis stages (p<0.001).
RVR was observed in 4⁄11 (36.4%) patients. Baseline CXCL10 levels were not significantly associated with RVR (P =0.185).Comparison between responders and non-responders using other parameters as age, gender, ALT, AST, ALT/AST, APRI test and viral load were also not significant.
EVR was observed in 60 ⁄ 84 (71.4%) patients. Baseline CXCL10 levels were significantly lower in responders (134.80±60.47 pg/ml, n=60) versus non responders (334.54±168.94 pg/ml, n=24, P value <0.001). Association between other parameters and EVR were not significant except for age and the degree of fibrosis (P value <0.001).
Assessment of response to treatment at week 24 during therapy showed that 6/84 (7%) patients were non responder (treatment failure). Baseline CXCL10 levels were significantly higher in non-responders (352.33±132.58 pg/ml, n=6) than responders (179.52±130.03 pg/ml, n=78, P value <0.002).
SVR was achieved in 58/68 (85.3%) patients. Baseline CXCL10 levels were significantly lower in patients who achieved SVR at week 24 post therapy than relapsed patients (CXCL10level:SVR, 179.52±130.03 pg/ml, n=58; Relapsed, 352.33±132.58 pg/ml, n=10, P = 0.021.