HCV has been encountered worldwide with World Health
Organisation (WHO) estimates of more than 170 million infected patients
in total; 130 countries and up to 90% of these will progress to chronic
Interestingly, genotype 4 represents over 90% of cases in Egypt. Chronic
HCV is the main cause of liver cirrhosis and primary liver cancer in
Egypt. (Arafa et al., 2005).
PEG IFN plus Ribavirin was more effective than standard
interferon-ribavirin combination or PEG IFN alone. SVR rates were
similar with both forms of PEG- interferon (α-2a and α-2b) when used in
combination with ribavirin(Shiffman et al., 2010).
Vitamin D is a potent immune modulator that is related to severity of
hepatic fibrosis and responsiveness to antiviral therapy (Petta et al., 2010).
The impact of vitamin D supplement on SVR of pegylated
interferon\ ribavirin-based treated patients is unknown. Recent data
reported that vitamin D supplement can improve virological response to
antiviral therapy (pegylated interferon/ribavirin) in genotype 1 infected
CHC patients(Abou Mouch et al., 2010).
The main aim of our work is to study the effect of vitamin D level on the
response of HCV to PEG interferone and ribavirin in the studied diabetic
group as the first step screening for the role of vitamin D level for
possibility of adding vitamin D to treatment of hepatitis C virus infection
This study was conducted in Kafr el sheikh liver and cardiac center
and Benha University hospital , it included forty diabetic patients with
proven chronic hepatitis C who have not been treated with any form of
interferon, and fulfill criteria of receiving interferon/ribavirin therapy.
Before treatment all patients were sampled for measuring vitamin
D serum levels by 25(OH) Vitamin D direct Immunodiagnostic ELISA Kit and Full clinical evaluation by detailed history and
physical examination. And other laboratory tests including
measurements HCV-Ab, HBS-Ag (those with HBS-Ag excluded from the
study) and quantitative PCR for HCV–RNA.
1. In addition to evaluation of CBC (Hb >11 g/dl), Absolute
prothrombin time and concentration (n=70-100%), serum albumin
(n=3.5-4.5 g/L), total serum bilirubin (n=up to 1.4 mg/dl), TSH
(n=0.4-4.5 µIU/ml), AFP up to 10, if AFP is abnormal but still <
100 IU/ml, C.T should be normal. fasting blood sugar within
2. Abdominal ultrasound and Liver biopsy according to (Ishak et al.,1995) to determine grade of necroinflamation and stage of liver
fibrosis to determine their eligibility for antiviral treatment.
There were forty patients are known to be diabetic . all of them
received the usual regimen of interferon [pegylated-interferon
subcutaneous (peginteron 150 mcg) ] weekly and oral ribavirin (800-1200
mg/d;.Follow up of patients after 12 weeks for vitamin D3 level and its
relation to response of therapy and developing side effects .
The results of this study revealed that most of CHC patients have
low vitamin D serum level in the studied diabetic group , varied from
mild to severe deficiency and the advanced degree of fibrosis was
associated with lowest vitamin D serum levels .
Also in mild deficiency at 12 th week all have negative PCR while in
severe deficiency 6/32 patients have positive PCR at 12 th week the result
was insignificant but give a message to investigate on larger number of
patients and also there was more decreasing in level of vitamin D at 12 th
week than 1 st week . It may be related to interferon and ribavirin effect .
Was ist eine Allergie? Eine Allergie ist eine überschießende Reaktion des Immunsystems gegenüber bestimmten körperfremden Substanzen der Umwelt. "Überschießend" heißt die Reaktion, weil das körpereigene Immunsystem auf Fremdstoffe (z.B. Pollen) anspricht, die anders als Krankheitskeime eigentlich keine Gefahr für die Gesundheit darstellen. Prinzipiell kann jeder S
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