Pattern of Skin Manifestations in Chronic Hepatitis c Virus Patients Before and After Direct Acting Anti Viral Drugs
Pattern of Skin Manifestations in Chronic Hepatitis c Virus Patients Before and After Direct Acting Anti Viral Drugs
-  Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that
 primarily affects the liver. It is one of the main causes of chronic liver diseases
 worldwide .

 -  According to World Health Organization (WHO), 2011 , Egypt has particularly high rates
 of Hepatitis C (22%).

 -  Hepatitis C virus (HCV) is known to induce both hepatic and extra-hepatic
 manifestations. About 17% of HCV patients present with at least one skin manifestation,
 which can be directly or indirectly induced by chronic HCV infection .
-  Skin diseases which are certainly related with chronic HCV infection are mixed
 cryoglobulinemia, lichen planus , porphyria cutanea tarda, Chronic pruritus and
 necrolytic acral erythema; conditions that may share a possible association with HCV
 infection .

 -  while several immune-mediated inflammatory skin conditions, such as psoriasis, chronic
 urticaria and vitiligo, have been only rarely reported in the setting of chronic HCV
 infection .

 -  Peginterferon based regimen with or without ribavirin were the mainstay of HCV treatment
 with a cure rate of about 50%, Although these regimens were lengthy, complex, had
 significant side-effects and high failure rates .

 -  They also had higher rate of exacerbated dermatologic conditions such as discoid lupus,
 psoriasis and Lichen planus .

 -  Recently, Newer all-oral anti viral drugs regimens began to be approved for use in 2014.
 These regimens, involve one pill daily for 12 weeks, they have achieved sustained
 virologic response of over 90% and have more tolerable side effect profiles.

 -  Recently, The European Association for Study of Liver (EASL) 2015, American Association
 for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America
 (IDSA) have now recommended that all chronically infected HCV patient should be offered
 treatment with new oral antiviral drugs .
Inclusion Criteria:

 1. Patients with HCV infection eligible for treatment with new (DAADs) and having:

 A- Normal Complete Blood Count ( hemoglobin not less than 10 gm/dl ). B- Mild to
 moderate impairment of Liver function test and kidney function test.

 C- Positive polymerase chain reaction for HCV virus. D- Controlled Blood sugar .

 2. Patients > 18 years

 Exclusion Criteria:

 1. Patients on treatment for skin disease.

 2. Pregnancy and lactation.

 3. Patients <18 years.

 4. Patients not eligible for oral anti hepatitis C drugs.