الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
The present study was conducted on 50 patients with chronic hepatitis c starting treatment on direct acting antivirals and these patients were selected randomly according to the inclusion and exclusion criteria.
Transient elastography was done to patients at baseline and 6 months after treatment and investigations including CBC, ALT, AST, Albumin, Bilirubin were done to patients before treatment and at the end of treatment and 12 Wks after end of treatment.
Also APRI score and FIB-4 score were calculated at baseline and at SVR.
The results obtained clearly demonstrated that :
ALT, AST, bilirubin, INR, AFP were significantly higher at baseline than after treatment while serum albumin was significantly lower at baseline.
FIB4 score, APRI score and LS values were significantly lower after treatment in comparison the values before treatment.
Hepatomegaly was found in 84.4%, Splenomegaly in 13.3%, the most common liver texture by sonography was bright texture ( 62.2%). LS stage 2 was found in 64.4%.
Regarding LS measurement, 11.10/o had non significant fibrosis < 7.1 Kpa (< F2), 64.4% had mild to significant fibrosis (≥7.1 to < 9.5 Kpa) (≥ F2 to < F3), 22.2 had advanced fibrosis (≥9.5) (≥F3) and 2.2 of the studied population had cirrhosis ( ≥12.5 Kpa) ( F4).
Hemoglobin and platelets were significantly lower in patients with high degree fibrosis in comparison to patients with low degree fibrosis before treatment while ALT, AST and AFP were significantly higher in patients with high degree fibrosis.
Hemoglobin and platelets were significantly lower in patients with high degree fibrosis in comparison to patients with low degree fibrosis after treatment while INR and AFP were significantly higher in patients with high degree fibrosis
FIB4 before and after treatment were significantly higher in patients with high degree fibrosis. APRI and LS scores were significantly higher in patients with high degree fibrosis while there were no differences between the two groups as regards APRI and LS scores after treatment.
Platelets and albumin were significantly higher in patients with improved LS score after treatment while AST, ALT, bilirubin and AFP were significantly lower in the same group.
FIB4 and APRI after treatment were significantly lower in patients with improved LS scores after treatment.
NAFLD score was significantly lower after treatment in comparison ti the value before treatment.
NAFLD scores were significantly lower in patients with low degree fibrosis than in patients with high degree fibrosis both before and after treatment
There were highly significant strong positive correlations between LS scores and FIB4, APRI score, ALT, AST, bilirubin, INR and AFP levels.
Hemoglobin, platelets, TLC and albumin were significantly negatively correlated to LS scores.
About 95. 6% of the patients achieved complete response while one patient ( 2.2%) was non responder and one patient ( 2.2%) was relapser.
In conclusion:
Direct acting antivirals are the effective treatment of patients with chronic hepatitis c.
TE must be a routine monitoring tool for liver fibrosis in patients receiving treatment with DAAs after treatment to evaluate the decrease of the stage of fibrosis .
Decrease of LS at the beginning results from improvement of the inflammatory changes but fibrosis changes require longer time to evaluate the degree of changes in the fibrosis stages.
The APRI and FIB4 scores showed significant improvement when measured at end of treatment, also platelet count, serum albumin and liver enzymes showed significant improvement at end of treatment.
Also NAFLD score showed improvement after treatment than before treatment.