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Background: A major impact of the IL28B gene polymor-phism on the response to antiviral therapy in chronic hepatitis C have been described recently by a lot of studies. This study aims to scrutinize the impact of IL28B genotypes of donors and recipients on the response to treatment with INF based therapy or DAA among patients that underwent liver trans-plantation. Aim of Study: This study aims to correlate IL28B genotype of donors and recipients for patients that had undergone liver transplantation with the response to INF based therapy, and the response to Direct Acting Antivirals (DAA). Patients and Methods: Donor and recipient IL28B geno-typing by PCR was done for 24 patients who experienced LT for HCV-induced end stage liver disease with established standard follow up evaluations post liver transplant for two years. Pegylated interferon-a (PEG-IFN-a) and ribavirin were received by 10 of the patients and direct acting antiviral (DAA) agents were offered to the remaining 14 patients. Results: We found that there was no impact of IL 28B polymorphism on the response to anti viral treatment (AVT) by (DAA) agents, as all different IL 28B genotypes and different recipient/donor patterns eventually achieved SVR even in cases with two unfavorable non-CC genotypes in both recipients and donors. We also found that the donor rs 12979860 CC genotype was strongly associated with the success of PEG-IFN-a and ribavirin treatment of recurrent hepatitis C. Conclusions: In the era of DAAs, it seems likely that it will be possible to overcome the effect of IL28B polymorphism with DAAs combinations.

Background: Recent studies have described a major impact of the IL28B gene polymorphism on graft survival post liver transplantation. Our study aims to investigate the impact of IL28B of donors and recipients on the natural course and outcome of liver transplantation due to end stage HCV related liver disease. Aim of Study: This study aims to investigate SNP of IL28B gene in Egyptian patients with end stage HCV related liver disease. Correlating the prevalence of IL-28b-alleles with patient and graft survival and with the progression of fibrosis for HCV-induced (graft) liver disease after liver transplantation. Also to correlate IL28B genotype with the outcome after liver transplantation. Patients and Methods: Donor and recipient IL28B rs12979860C>T single nucleotide genotype was determined in 24 patients who had undergone LT for HCV-induced end stage liver disease and received regular follow-up evaluations for two years post liver transplantation. Results: We found that the CC genotype frequency was reduced among patients with HCV related end stage liver disease while, in contrast, the frequency of CT & TT increased. No association was noted between IL 28B polymorphism of donors and recipients regarding fibrosis progression or patient and graft survival, as well as liver outcomes. Conclusions: No impact of IL 28B polymorphism on fibrosis progression, liver outcomes or patient and graft survival.

BACKGROUND Transient elastography and acoustic radiation force impulse (ARFI) imaging are noninvasive tools for liver stiffness measurement (LSM), which may be influenced by cholestasis. AIM The aim of the study was to evaluate the performance of transient elastography and ARFI in extrahepatic cholestasis and correlate changes in LSM with biochemical activity. MATERIALS AND METHODS A total of 38 patients with extrahepatic cholestasis prospectively underwent transient elastography and ARFI. Changes in LSM by transient elastography/ARFI were evaluated after 1 week of ERCP and correlated with biochemical parameters. The optimal ARFI cutoffs according to stages of clinical interest were analyzed. RESULTS Biliary obstruction was calcular in 21 (55.3%) and noncalcular in 17 (44.7%) (benign n = 15, malignant n = 2). After 1 week, adequate biliary drainage reduced total bilirubin from 7.7 to 2.2 mg/dL (P

Liver fibrosis is a common pathway leading to cirrhosis, which is the final result of injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Liver biopsy has been considered to be the “gold standard” to assess fibrosis. However, liver biopsy being invasive and, in many instances, not favored by patients or physicians, alternative approaches to assess liver fibrosis have assumed great importance. Moreover, therapies aimed at reversing the liver fibrosis have also been tried lately with variable results. Till now, there has been no consensus on various clinical, pathological, and radiological aspects of liver fibrosis. The Asian Pacific Association for the Study of the Liver set up a working party on liver fibrosis in 2007, with a mandate to develop consensus guidelines on various aspects of liver fibrosis relevant to disease patterns and clinical practice in the Asia-Pacific region. The process for the development of these consensus guidelines involved the following: review of all available published literature by a core group of experts; proposal of consensus statements by the experts; discussion of the contentious issues; and unanimous approval of the consensus statements after discussion. The Oxford System of evidence-based approach was adopted for developing the consensus statements using the level of evidence from 1 (highest) to 5 (lowest) and grade of recommendation from A (strongest) to D (weakest). The consensus statements are presented in this review.