الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hepatic fibrosis is a dynamic scarring process in which chronic inflammation stimulates production and acxcumulation of cxollagen and ECM. The HSCs are the primary cells responsible for producing these ECM proteins. Pathological accumulation of the ECM is the main feature of fibrogenesis; that indicates the imbalanced rate of increased matrix synthesis to decreased breakdown of connective tissue proteins which is regulated by the MMPs and TIMP-1. Remodeling of ECM is associated with the regulation of different levels of MMPs, which is mediated by regulated MMPs gene expression, activation of MMPs, and TIMPs.
Chronic hepatitis C Patients are susceptible to hepatic inflammation, developing liver fibrosis, cirrhosis and HCC. Such a case dose not depend on virus genotype or viral load. Over time, with CHC infection, the total collagen content increases and fibrosis can develop, with potential progression to cirrhosis and/or HCC.
In previous years, there was a growing interest in establishing noninvasive alternatives to liver biopsy for fibrosis staging. Initial screening with simple laboratory tests, such as platelet count, prothrombin time, albumnin, total bilirubin, and serum aminotransferase levels are commonly performed in clinical practice in an attempt to estimate fibrosis and identify overt cirrhosis. Studies have examined the use of different combinations of these measures to evaluate hepatic fibrosis.
None of these markers have yet to evolve as a standard of practice or primary means to assess liver fibrosis. So that, liver biopsy still the gold standard for diagnosing and establishing the severity of liver fibrosis.