الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
It’s well-known that Hepatitis C virus infection is considered a systemic disease, and among extra-hepatic manifestations, insulin resistance and diabetes are reported to be associated with high frequency to the infection.
Experimental & clinical evidences demonstrated that HCV core protein plays a pathogenic role in the development of insulin resistance. It has been reported that the risk of developing type 2 diabetes mellitus is 11 times higher in patients with HCV infection, in which there is a direct correlation between viremia and IR levels and the development of type 2 diabetes (Adinolfi et al., 2016)
The aim of this study is to evaluate the role of Resistin in detecting Insulin Resistance and their impact on response to direct acting antiviral in chronic hepatitis C patients.
This prospective Cohort clinical study was conducted on40 Egyptian patients who were ≥18years of age having chronic viral hepatitis C and 10 healthy control, recruited from Ain shams university hospital center for treatment of viral hepatitis.
Our Results showed and compared the three study groups as regards fasting insulin level, HOMA-IR and Serum Resistin Level pre-treatment, which shows statistical significance being higher in naïve and relapser in comparison to control with P-value <0.001.
Also comparison between the two groups as regards FBS, Fasting Insulin Level, HOMA-IR equation and Serum Resistin Level pre-treatment and post-treatment, in the Naïve group with which shows statistical significance being higher in naïve and relapser pre-treatment with P-value <0.001 in both groups.
Also comparison between the two DAA regimens used in Naïve group Sof/Dacla and Sof/Dacla/Riba or the two DAA regimens used in relapser group Sof/Qurevo/Riba and Sof/Dacla/Riba as regards change in FBS, FASTING insulin, HOMA-IR and Resistin level before and after treatment showing no statistical difference between both regimens in all 4 parameters, showing no superiority for any group over the other as regards improvement of insulin resistance.
Also there is clearly a strong correlation between change of HOMA with change of Resistin level (both decrease in level) before and after treatment, in both naïve and relapser groups, with r value 0.494 and 0.51 respectively, And a strong correlation between HOMA-IR pre-treatment and Fasting insulin level in both Naïve and relapser group with r value equal 0.856 and 0.794 with P-value <0.001, and with FBS pre-treatment in naïve group with r value equal 0.667 and P-value 0.001 and Resistin level with r-value 0.745 and 0.769 respectively with P-value <0.001.
And we found a strong correlation between resistin level pre-treatment and Fasting insulin level in both Naïve and relapser group with r value equal 0.756 and 0.725 with P-value <0.001, and with FBS pre-treatment with r value equal 0.695 and P-value 0.001, and with HOMA-IR pre with r-value 0.877 and 0.789 respectively and P-value <0.001.
Lastly, after all the benefits and in spite of all the drawbacks of DAAs clearing the Viral hepatitis C infection, we clearly see a new and important extra-hepatic benefit which is improving the insulin resistance adding more and more to the marvelous benefits of DAAs, which is considered one of the greatest Medicines ever used in all the history of Medicine saving the lives of millions of patients, and helping our Land to recover from one of the most deadly diseases ever known in Egypt, after treating millions of Egyptians in the National Campaign last year and till this very day, Saving more and more lives of our people.
But the question is, whether this effect is maintained over the long term with a significant clinical impact is still a matter of debate.
Finally, Our Ultimate target as Hepatologists worldwide is to eliminate HCV infection by 2030, And To see the world Free from this deadly virus.