Background IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients in the non-transplant setting. Objective To determine the prevalence and impact on clinical outcomes of donor and recipient IL28B genotypes among liver transplant recipients receiving directly acting antiviral therapy compared to those of HCV non-transplant patients. Patient and Methods This study included 60 patients divided into 2 groups: group 1 included 30 patients subjected to living donor liver transplantation and group 2 included 30 patients of HCV infection. Each group was subdivided into group A and group B according to the regimen of directly acting antiviral therapy (sofosbuvir-ledibasvir, sofosbuvir-daclatasvir). Liver transplantation was done between January 2016 and April 2018. Genotyping of the polymorphism was performed on DNA collected from all donors and recipients in group 1 before and after liver transplantation and also collected from all patients of group 2. Sustained virological response was found in 28 patients in group 1 (transplanted group) and 29 patients in group 2 (non-transplanted group) with no significant difference. Results No significant difference also was found in both groups according to the type of regimen. Also the type of genotype CC, CT and TT of IL28B in donors and recipients were not significantly associated or affecting the results of SVR in both groups of patients. Conclusion Our results support no role of recipient IL28B genotype in the response to directly acting antiviral drugs for hepatitis C recurrence. Interestingly, donor genotype seems not to influence the response pattern in recipients who have different IL28B genotype.

Background: Dyspepsia is a frequent symptom in cirrhotic patients . Congestive gastropathy or portal hypertensive gastropathy (PHG) was detected as a possible cause of sustained dyspepsia in 40% of these patients , and prolonged gastric emptying time(GE) with decrease gastric wall compliance were detected in cirrhoric patients .Electrogastrography (EGG) is a non-invasive method to study gastric myoelectrical activity from the body surface by electrodes . whereas, an ultrasonographic method can be used for the estimation of gastric emptying by measuring what so called half emptying and full emptying times with other parameters.Aim of this work is to study patterns of EGG & ultrasnographic GE. In cirrhotic patients with or without PHG . 45 patients were chosen for this study and were divided into 3 groups ; group 1 is cirrhotic patients with PHG negative upper gastrointestinal ( U.G.I.T.) endoscopy & group 2 is cirrhotic patients with PHG positive & group 3 is healthy subjects taken as control .Results :-we found significant delay in GE in gp. 2 in relation to group 3 (p < 0.05 ).EGG reveiled power ratio lower in gp. 1, 2 ( 2.01 -1.93 ) respectively compared to group. 3 (2.63). Also there was highly significint increase in "Dominant frequency" at rest ( DF ) in group.1 campared to group. 2 & 3 ( p>0.01) where mean of group 1 was 2944.9 , in group 2 was 2477 and in group 3 was 1934 & the power meal at DF was higher in group 1 than 2 , 3 but siatistically insignificant where the mean in group 1 was 5922.5 & in group. 2 was 4804.8 and was 5087.8 in group 3 (p>0.05) conclusion :-Delayed gastric emptying by U.S, and changes in EGG records of cirrohotic patients especially in presence of portal hypertensive gastropathy may explain dyspepsia frequently occurring with portal hypertensive gastropathy.

Background: Hepatocellular carcinoma is a highly prevalent tumor globally and the world's second leading cause of cancer-related deaths. Glypican-3, a heparan sulfate proteoglycan expressed on the surface of HCC cells, has emerged as a new molecule with a strong link to occurrence and progression of HCC. Objective: This study was done to determine the role of Glypican-3 in diagnosis of HCC and its prognostic value following different treatment modalities. Patients and methods: The study included thirty patients with liver cirrhosis and HCC on top, and thirty patients with liver cirrhosis without HCC. Standard laboratory investigations, abdominal ultrasound and triphasic computed tomography were done for all patients. Serum alpha fetoprotein and Glypican-3 were measured in all patients before and one month after different treatment modalities. Results: Glypican-3 was significantly higher in HCC group (2.28 ± 0.97) in comparison to cirrhosis group (0.56 ± 0.31) with P-value <0.001. Glypican-3 level was higher in larger sized lesions with p value 0.023, one month after treatment with different modalities, Glypican-3 declined significantly (from 2.28 ± 0.97 to 1.44 ± 0.93) with p value <0.001. At a cutoff point of > 1.1 ng/ml Glypican-3 has 93.3% sensitivity, 96.67% specificity, 96.6% PPV and 93.5% NPV for detection of HCC. Conclusion: Glypican-3 can be a valuable diagnostic marker for HCC diagnosis and prognosis after various treatment modalities and may be complementary to alpha fetoprotein increasing overall sensitivity of HCC detection.

Background:In Nonalcoholic fatty liver disease (NAFLD), histopathological differentiating from simple steatosis to nonalcoholic steatohepatitis (NASH) can only be confirmed by liver biopsy. These is new promising non invasive marker , Plasma pentraxin (PTX3) to discriminate NASH from non-NASH patients, and it is related to degree of liver fibrosis in NASH patients.Objectives: our aim is to investigate the clinical usefulness of plasma Pentraxin3 (PTX3) levels versus fibroscan to predict NASH and the potential relationship of its levels with the degree of liver damage in NAFLD /NASH Egyptian patients Methods: Plasma PTX3 levels & traniset elastogrophy (fibroscan) measurements were estimated in 60 Eqyptain patients with NAFLD (30 with NASH, 30 with non-NASH) and 20 healthy controls.Results: PTX3 levels were found significantly higher in the NAFLD group than in the control group (P < 0.001), and in NASH subgroup than non-NASH subgroup (P=0.001). To discriminate NASH from non-NASH, PTX3 had 96.67% sensitivity and 93.33% specificity at the cutoff value of 3.1ng/ml. Plasma PTX3 levels showed no significant correlation with NAFLD activity score, fibrosis stage and steatosis. Conclusion:This study demonstrated markedly higher PTX3 levels in NAFLD patients compared with controls, and in NASH patients compared with non-NASH ones and no correlation with fibroscan stages. Thus, in this cohort we showed that plasma PTX3 may be a promising biomarker for the presence of NASH.

Background: Hepatitis C virus (HCV) infection is a progressive disease that may result in chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Itis estimated that about 160 million individuals are chronically infected with HCV. Hepatocellular carcinoma (HCC), the fifth most common cancer in men and the ninth in women, represents an urgent clinical problem, being the second leading cause of cancer-related death worldwide. Aim of the study: To determine whether VWF is a potential biomarker for liver fibrosis in comparison to other markers of fibrosis and predictor for development of Hepatocellular Carcinoma in comparison with Alpha-feto protein and Des Gamma carboxy prothrombin. Patients and Methods: This study had been carried out on 50 subjects, age range 34-77 year selected from Virology and Hepatology outpatient clinics at Ain shams university hospitals in Cairo after informed consent were taken from the patients. Subjects were divided as follows: Group I: Include 20 HCC patients diagnosed by imaging and alphafetoprotein. Group II: Include 20 matched cirrhotic patients without HCC divided according to childpugh scoring system. Group III: Include 10 apparently healthy subjects, age and sex matched, having no acute or chronic illness and taking no medications were taken as control group. Results: In our study, VW factor was statistically significant higher in cirrhotic patients than control group and in patients with HCC than cirrhotic group without HCC, with weak positive correlation with other markers of liver fibrosis (FIB4, APRI), and weak positive correlation with other markers of hepatocellular carcinoma (alpha feto protein, des gamma carboxy prothrombin). VW factor was statistically significant higher in advanced stages of liver cirrhosis. Conclusion: In conclusion; VWfactor is statistically significant higher in patients with Hepatocellular carcinoma than in cirrhotic patients without HCC. There is weak positive correlation between VW factor as a biomarker for liver fibrosis and other scores assessing stage of fibrosis. There is a strong correlation between VW factor and child score used to classify stage of liver cirrhosis, so VW factor is valuable predictor for hepatocellular carcinoma and advanced stages of liver cirrhosis.