الفهرس 
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Abstract
(HCV) is a worldwide cause of chronic liver disease particularly in Egypt where the main genotype which is responsible for over 90% of infections is genotype 4
Sarcopenia is a progressive loss of muscle mass representing frequently unseen complication of CLD, reflecting the poor nutritional status in cirrhotics cause significant morbidity and mortality, which affect (HRQOL) of the patients as they became physically and mentally impacted by fatigue, depression and anxiety.
Significant metabolic changes of protein, carbohydrates and lipids appear simultaneously with the consumption of muscular and lipid compartments to meet a higher energetic demand had place in patients with chronic hepatopathy
Multiple Anthropometric tools were used to evaluate patients’ nutritional status include BMI, and mid-arm circumference HGS can assess muscle strength as a marker of muscle tone.
BMI is the most used tool as it familiar to most clinicians, however, it is limited due to its inaccuracy in patients who have significant ascites, leading to overestimate the nutritional status of patients with liver disease, so HGS may be better able to predict malnutrition-related outcomes at 1 year
This study was carried out on 150 subjects were divided into three groups matched as regard age and sex.
– group (A): healthy controls (n=50)
– group (B): Patients with HCV CLD (n=50).
– group (C): Patients with HCV Cirrhotic liver (n=50)
In order to evaluate the effect of the direct acting antivirals therapy on nutritional status in HCV chronic liver disease Egyptian patient before and after DAAs
Our study showed significant improvement in the (HGS) assessment and significant decrease in the body weight, body mass index (BMI) and mid arm circumference (MAC) of the study groups at SVR 12 weeks after receiving DAAs regardless the protocol of treatment, however insignificant correlation between MAC and the HGS before and after treatment was present as HGS concerned mainly to the functional state of the muscle more than the skeletal muscle mass.
Also, the s. albumin was only insignificantly increased and the weight was significantly decreased in both groups at 12-week SVR in contrast to other studies showed simultaneous increase of skeletal muscle mass and serum Albumin levels occurred in patients with LSM.
In conclusion: HGS is gold standard in assessment of nutritional state and nutritional supplementation is complementary to DAA in improve the outcome in HCV chronic liver disease patient and further the HRQOL.