Subject Area

Internal Medicine

Article Type

Original Study


Objectives: to assess the prevalence and factors that predict HCV relapse after direct acting antiviral drugs (DAAs (

Background: Egypt is known to be one of the countries with heavy HCV infections.The introduction of DAAs has represented a paradigm shift inHCV management.

Patients and methods:The current study was retrospective study made on 422 consecutive cases with HCV, who were selected from those attending viral hepatitis C unit at Shebin El-Khom teaching Hospital, Egypt from March 2019 to March 2020. All cases were subjected to thorough history taking, full clinical examination and laboratory tests as Liver function profiles, Renal function tests, Complete blood count, Serum alpha fetoprotein, Viral markers, and imaging data as (Abdominal ultrasonography- Triphasic CT.

Results: ALT, AST, creatinine, FIB 4, direct bilirubin, albumin, PCR, and INR showed significant increase in non-responder when compared to responders. Platelet showed significant increase in responder when compared to non-responders.Treatment experience, high viral load,and appearance of liver cirrhosis (US) and FBI-4 were independent RF for relapse between the studied cases with odds ratio respectively. FIB-4 showed AUC of 0.744, and showed at a cutoff point (0.996), sensitivity was 75%, specificity 61%, +ve predictive value (10.2%) and -ve predictive value (98.2%). regarding viral load, AUC was 0.729 and at a cutoff point 860063.0, sensitivity was 70%, specificity 65.5%, PPV 9.0% and NPV 97.7%.

Conclusion:Simple basicinvestigations(CBC,liver function tests, renal function tests, ultrasound) and cases characters(age, gender,DM,HTN, smoking) are predictors of unresponsiveness and selection of more potent regimens aiming at possible eradication.