Evaluation of the National Treatment Program of Hepatitis C in Egypt

Inclusion Criteria: * Age \< 18 years and \> 60 years * Positive HCV antibodies using a third generation test * Detectable HCV RNA by PCR * Liver biopsy showing chronic hepatitis with either a METAVIR score F1 with elevated liver enzymes or scores F2/F3 * Naïve to treatment with PEG-IFN and RBV * HBs antigen negative * Prothrombin time ≥60 %, normal bilirubin, alpha-foeto protein \< 3\*normal range of the laboratory, anti-nuclear antibodies\<1/160 * Effective contraception during the treatment period; no breast-feeding * Signed informed consent and willingness to participate in the study Exclusion Criteria: * Serious co-morbid conditions such as severe hypertension, heart failure, significant coronary heart disease, poorly controlled diabetes (HbA1C\>8%) , chronic obstructive pulmonary disease * Major uncontrolled depressive illness * Solid transplant organ (renal, heart, or lung) * Untreated thyroid disease * History of previous anti-HCV therapy * Body mass index (BMI) greater than 30 kg/m² * Known human immunodeficiency virus (HIV) coinfection: although HIV testing will not be proposed or done, patients with known HIV coinfection will not be included in the trial * hypersensitivity to one of the two drugs (PEG-IFN, RBV) * pregnancy or unwilling to comply with adequate contraception * breast-feeding * neutropenia (\<1500/mm3) * anaemia (\<11g/dL for women ; \<12g/dL for men) * thrombocytopenia (\<100.000/mm3) * elevated creatinin (\>1.5mg/dL) * concomitant liver disease other than hepatitis C (immuno-active chronic hepatitis B, autoimmune hepatitis, alcoholic liver disease, hemochromatosis, alpha-1 antitrypsin deficiency, Wilson disease) * liver biopsy showing severe steatosis (\>66%) and steatohepatitis; decompensated cirrhosis (Child Pugh\>A); hepatocellular carcinoma, METAVIR score F4. * TSH\>5 mU/L