الفهرس 
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Abstract
This study was conducted on (80) patients in addition to (20) apparently healthy subjects served as control group from June 2016 to March 2017.
All studied subjects were classified into three groups:-
group I :
Included (40) cirrhotic patients with un treated hepatitis c virus.
group II:
Included (40) cirrhotic patients with treated hepatitis c virus.
group III:
Included (20) apparently healthy individuals (control group).
All the groups were subjected to full medical history, physical examination and Hamilton depression rating scale, then followed by qualified HCV virus tests (rapid, ELISAAND RT-PCR), liver and kidney function tests , CBC, AFP and lastly tryptophan and phenylalanine measurement by HPLC- UV .
There was non statistical significant difference between patients and control groups regarding age or sex, but there is highly statistical significant decrease in treated HCV cases than untreated HCV cases regarding medical history.
There are 8 cases with D.M. only and another 8 cases with D.M. with hypertension and 4 cases with diabetes and obesity among studied groups.
There is no statistical significant difference between three groups regarding liver function tests. Applying bonferroni test, there is a statistical significant increase in ALT, AST and AFP values in treated than control cases. There is statistical significant increase in AST and AFP values of treated than untreated cases.-There is a statistical significant increase in direct Bilirubin values in untreated cases than control cases.
There is a statistical significant difference between three groups regarding creatinine and Urea. Applying bonferroni test, there is a statistical significant increase in creatinine in treated cases than untreated cases. There is statistical significant increase in urea in treated cases than control cases.
There is a statistical significant different between three groups regarding HB (hemoglobin) and PLT (platelets). By post-hoc test, there is a high statistical significant decrease in HB and PLT (platelets) in treated cases than control cases. There is a statistical significant decrease in HB and PLT( platelets) in treated cases than untreated cases.
There is a statistical significant difference between three groups regarding amino acids(tryptophan and phenyl alanine). By post hoc test, there is a high statistical significant decrease in tryptophan in treated cases than untreated cases, there is a high statistical significant decrease in tryptophan in treated cases than control cases.
There is a statistical significant difference between three groups regarding phenylalanine.-There is a high statistical significant increase in phenylalanine in treated cases than control cases. There is a statistical significant increase in phenylalanine in untreated cases than control cases. There is a high statistical significant increase in phenylalanine in treated cases than untreated cases.
There is statistical significant difference between three groups regarding HDRS (Hamilton Depression Rate Scale) -There is high statistical significant increase in treated cases than untreated cases regarding grade of depression. There is a high statistical significant increase in treated cases than control cases regarding grade of depression.
There is a statistical significant difference in phenyl alanine and tryptophan levels regarding severity of depression among treated group. There is statistical significant increase in tryptophan level and decrease in phenylalanine level in Mild/Moderate than very severe cases.
At a cut-off of 2.13 ug/ml, phenylalanine had 96.9% sensitivity, 62.5% specifity, Area under Curve (AUC) 0.848 for prediction of severe depression among treated cases. At a cut-off of 8.53ng/ml, tryptophan had 81.2 % sensitivity, 75% specifity, AUC 0.812 for prediction of severe depression among treated cases.
40 case of treated HCV patients with concentration range of PCR( 0.12 -131) ×105 with Mean of PCR concentration was (21.55) as the standard deviation was (27.25)
- 40 case of untreated HCV patients having ELISA concentration rang (35.1 – 241) with mean (127.1) and standard deviation (57).
There is a statistical significant negative correlation between tryptophan and HDRS Scale. Also there is a statistical significant positive correlation between phenylalanine and HDRS Scale. There is no statistical significant correlation between other studied variables and HDRS Scale among treated groups.
-There is no statistical significant correlation between all studied variables and HDRS Scale among untreated groups.
This table shows that phenylalanine and tryptophan levels are significant (P<0.05 for both) predictors of HDRS (severe depression).