الفهرس 
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Abstract
Hepatitis C virus is often silent, but histologically it is associated with evidence of progressive disease leading to cirrhosis and hepatocellular carcinoma
The aim of this study is to evaluate biomarkers of hepatic and extrahepatic manifestations of chronic hepatitis C patients. This study, also, aims to throw light on their great importance and how they provide help for HCV infected patients, regarding diagnosis and progression of the disease as well as its management.
Direct and indirect markers of chronic HCV are:
I- Direct markers: Collagens, Glycoproteins and polysaccharides, Collagenases and their inhibitors and Cytokines.
II- Indirect markers: AST/ALT ratio, PGA index, Fibrotest, ACTI test, Steato test, Forns index, APRI (AST to Platelet Ratio Index) and Göteborg University Cirrhosis Index (GUCI).
Hepatitis C virus infection is not confined to the liver, but can induce disturbances in many other organs and systems. Extrahepatic manifestations (EHMs) may represent the first signal of HCV infection, as many patients show no hepatic symptoms. Some of these EHMs are:
• Haematologic disorders (MC, ITP, AHA, LPDs, lymphoma and monoclonal gammopathies).
• Endocrine disorders (Thyroid gland disorders, DM, insulin resistance and sex disorders).
• Autoimmune disorders (SLE, myasthenia gravis).
• Renal diseases (GN).
• Dermatologic disorders (Lichen planus, Porpheria cutanea tarda and Necrolytic acral erythema).
• Rheumatologic disorders (Sjogren syndrome (SS) and Poly arteritis nodosa).
• Psychological and neurological disorders.
• Ocular disorders.
• Cardiovascular disorders.
Serum markers are a promising alternative to liver biopsy for many patients with liver diseases, where they are less invasive and may be more cost effective.