Introduction:
Pharmacistsalready have an essential role in screening for Diabetes
mellites and Cardiovascular risk and their involvement has beneficial
effects in patient education and disease management
[1]
[2]. Pharmacist-led health screening
represents a great opportunity to potentially engage pharmacists with
patients who may be less likely to access physicians including elderly
patients, and patients from lower socio-economic status
[3]. The majority of research in
hepatitis C disease focused on the detection , diagnosis and treatment.
However, in this research we focused on the metabatic and hypertension
risk associated with hepatitis C infection in Egyptian population. Virus
C is considered as a gigantic endemic therapeutic health issue in Egypt
[4] . Egypt was found to have the most
elevated recorded predominance of HCV in the world
[5]
[6]. Incidence rate is between 2 and 6
per 1000 case per year and 170,000 new cases are added each year
[4] . Although mortality related to
HCV infection will continue to extend over the following 20 years but,
with successful therapeutic strategies it may be eliminated within 15-20
years [6]. Therefore , Egypt has
propelled an ambitious new national treatment program in 2014
[7] . The Egyptian national HCV
treatment program is considered one of the foremost fruitful, compelling
and promising public health programs
[8] .Chronic hepatitis C is the most
cause of cirrhosis and hepatocellular carcinoma. Hepatitis C is
characterized by being a slowly progressing liver illness, which implies
that cirrhosis may happen almost 20–30 years after infection
[9] . The primary host cells for HCV
are hepatocytes. Viral entry into hepatocytes occurs following to its
binding to low-density lipoprotein receptors. Once internalized, HCV
interferes with the host lipid metabolism for its replication and
assembly, which consequently leads to hepatic steatosis. Hepatic
steatosis could be a condition in which there is excessive accumulation
of triglycerides inside the hepatocytes. Strong epidemiological,
biochemical, and therapeutic evidence implicate insulin resistance as
the essential pathophysiological key mechanism driving to hepatic
steatosis. A mixture of several host and viral factors cause hepatic
steatosis[10] . First, host factors
incorporate the metabolic syndromes such as obesity and type 2 diabetes
mellitus (T2DM), hypertension, alcohol abuse and medication use. Second,
hereditary factors as interleukin 28B polymorphism. Third facor is viral
components as genotype (genotype 3 prima rily cause steatosis), and gene
mutation [10] . It is very useful to
distinguish modifiable risk factors that contribute to HCV progression
it may guide treatment approaches and overall disease management. Impact
of obesity and DM have been entangled within the progression of hepatic
fibrosis and cirrhosis [8]. Recently, many studies have suggested
that chronic hepatitis C virus infection (CHC) is associated with T2DM,
However the association between CHC and T2DM is not consistent across
all studies [11] . Another study in
France detailed that HCV frequency was significantly related with age
[12] . Previous studies demonstrated
that HCV infection might not only resist antiviral course of treatment
but also moreover advancement of fibrosis may happen which is due to
expanded proficiency of viral replication by lipid accumulation in cells
[11] . Lessening in complications
from T2DM that follows effective antiviral treatment was detailed in
later clinical trials [13] . The
current study points to target high risk HCV Egyptian patients with
metabolic disorders including diabetes, obesity , hypertension , age and
sex then estimate the potential risk factors associated with hepatitis C
patients and determine the impact of different screening methods for
identifying and treating people at high risk