The Role of Retinol Binding Protein 4 (RBP4) in Prediction of Response to New Direct Acting Antiviral Drugs (DAAS) in Chronic Hepatitis C

Abstract

Background: Hepatitis C virus is global health burden and major health hazard in Egypt, Since the virus is the etiological factor of chronic hepatitis that frequently progress to a Cirrhosis and hepatocellular carcinoma (HCC).In addition to cirrhosis and hepatocellular Carcinoma, HCV is thought to cause metabolic alterations, including steatosis, dyslipidemia, insulin resistance (IR), diabetes, obesity and cardiovascular events. Objective: To determine the value of RPB4in the prediction of response to new DAAS. Treatment in chronic HCV infected patients and to correlate its level with their catabolic Profile and fibrosis degree among chronic HCV Patients and Methods: This study was Prospective cohort clinical study that was Conducted at hepatology and virology outpatient clinic at Ain Shams University Hospital & Hepatology and virology outpatient clinic at Kafr–Sheikh liver institute from January 2019 to October2019after informed consent. Results: The present study showed that the best level of RBP4in prediction of hepatic Fibrosis stage4was≤46pg/ml and had sensitivity of 100% while the specificity was 66.67%.The positive predictive value was50% while the negative predictive value was100% and test accuracy was80.5%. Conclusion: Serum RBP4 was found to be higher in chronic hepatitis C naïve patients than Normal person; there was significant reduction of RBP4 post treatment. Fibroscan showed Marked reduction of fibrosis degree after treatment with directly acting antiviral in both cirrhotic and non-cirrhotic patients regardless the treatment regimen used with improved. Over all liver function tests, liver enzymes and platelet count in patients who reached SVR And maintained negative PCR after treatment. Keywords: HCV, DAAs, RBP4.