الفهرس | Only 14 pages are availabe for public view |
Abstract HCV infection is a global health issue and one of the major causes of chronic liver diseases, Egypt on the top of the countries with heavy HCV burden, HCV genotype 4 is the most common in Egypt and represents 92% of total infections. The goal of HCV therapy is eradication of the HCV which determined by sustained virological response (SVR) in order to prevent the complications which include liver fibrosis, cirrhosis, portal hypertension and hepatocellular carcinoma. The availability of direct acting antiviral drugs (DAAs) improves rates of sustained virological response (SVR). Viral eradication decreases liver damage by improving the inflammation, as well as by regressing fibrosis irrespective of the treatment regimen of DAAs. Non-invasive methods are useful in the assessment of liver fibrosis, but their usefulness for monitoring fibrosis after SVR needs to be demonstrated. Portal hypertension is a common complication of liver cirrhosis which leads to the formation of gastroesophageal varices when HVPG ≥10 mmHg which is called clinically significant portal hypertension. This aim of our study was to asses changes on the size of esophageal varices and liver stiffness after treatment of HCV with DAAs. The study was carried out at Gastroenterology and hepatology Department, Ain-Shams Hospital and Kobry-Elkoba Military Hospital and included 60 patients with chronic infection of hepatitis c Summary 146 virus diagnosed by (HCV Ab by ELISA positive and HCV RNA by PCR positive) and was divided into 3 groups: group I : 20 patients chronically infected with HCV received sofosbuvir(one 400mg tablet taken once daily) & Ribavirin (weight – related dose ,75 kg or less :400 mg orally in the morning and 600 mg in the evening ,Greater than 75 g :600 mg orally twice daily and decrease the dose in case of anaemia ) for 6 months. group II: 20 Patients chronically infected with HCV received sofosbuvir(one 400mg tablet taken once daily) & simeprevir( one 150 mg tab taken once daily ) for 3 months. group III: 20 patients chronically infected with HCV received sofosbuvir (one 400mg tablet taken once daily with or without food) & daclatasvir(one 60 mg tab taken once daily ) for 3 months. In the study, patients achieved high rates of SVR 12(98.3%) only one patient at group II relapsed after finishing the treatment and did not reach SVR12. In the study, there was decrease in fibroscan stages after treatment with different regmins of DAAs, but it was significant with group III (HCV patients who received sofosbuvir & daclatasvir for 3 months) In the study , There is significant improvement in liver enzymes (AST&ALT) and significant increase at platelet count after treatment in all the 3 groups, Also there was significant decrease in hemoglobin level in group I (SOF/RIB) in comparison to other groups. Summary 147 In the study, there was no significant change in OV grading in group I before and after treatment, and also in group II & III only one patient in each group had changes in OV grading after treatment from OV grade III to OV grade II. |