الفهرس | Only 14 pages are availabe for public view |
Abstract HCV infection is one of most serious health problem in Egypt with mean prevalence of 22%. IR is associated with HCV genotypes 1, 3 and 4. Elevated iron stores and TNFα are thought to be involved in the pathogenesis of IR in HCV patients. Our objective was to study the possible role of ferritin and TNFα in the pathogenesis of IR and to study the inter-relationship between HCV induced IR and treatment outcome in pateints with genotype 4. The study was conducted on 118 patients with chronic HCV genotype 4 proved by HCV RNA using PCR techniques preparing for antiviral therapy. They were screened for insulin resistance by calculation of HOMA-IR. The patients were recruited into 2 groups, group (A) representing 43 insulin resistant patients (HOMA-IR > 2). Group (B) represents 43 randomly selected patients with HOMA-IR ≤ 2. The age and sex of group (B) patients were matching with that of group (A). All patients had BMI<30 & nondiabetic & with negative results for HBsAg and HIV Ab. The control group was Twenty two healthy volunteers with age and sex matching with the patients groups, with negative results for anti HCV antibody by ELISA. Hepatic steatosis and fibrosis was assesed histologically from ultrasound guided liver biopsy. Before starting antiviral therapy the levels of HOMA-IR, serum ferritin and serum TNFα were measured for patients and control subjects. After 12 weeks antiviral therapy HOMA-IR, serum ferritin and serum TNFα were measured for the responders of the insulin resistant group. |