1. The clinical and the prognostic value of Insulin, Growth Hormone,TNF-R (P55) and IL-1 receptor antagonist (IL-1ra) in ChronicHepatitis due to HCV Genotype 4 before and after combinationtherapy with Pegylated Interferon -2a and Ribavirin.Nihal M.El Assaly1, Naema El Ashri1, Omnia El Bendary1, Shendy M.Shendy2 , Mervat Al-Damarawy3, M. Ali Saber 4 and Ehab El Dabaa41. Clinical Chemistry Department. Theodor Bilharz Research Institute (TBRI), 2.Gastroenterology and Hepatology Department (TBRI) 3. ICU department (TBRI). 4.Biochemistry Department (TBRI).Journal -Egyptian Medical Journal Of The National Research Center, June 2007; vol. 6 (1):38 45.35401019.AbstractCombined therapy using Interferon alfa (IFN) and Ribavirin (RIB) represents the standard treatment inpatients with chronic hepatitis C. However, the percentage of responders to this regimen is still low, whileits cost and side effects are elevated. Therefore, the possibility to predict patient's response to the abovetreatment is of paramount importance. Aim of this work is to evaluate the role of IL-1ra, and TNFaRI(P55) which are receptors related to inflammatory response and, GH and Insulin which are hormonesmetabolized in the liver as biochemical non invasive markers of severity of liver disease due to HCVinfection genotype 4, whether cirrhotic or non-cirrhotic. The effect of interferon alpha 2a and ribavirintherapy on their levels and whether they could be used as parameters predicting the outcome of interferonalpha 2a therapy in patients with chronic HCV infection . Methods 54 patients infected by HCV genotype4 were enrolled in this study. They were classified into two groups according to the liver histology. GroupA of 42 chronic compensated HCV patients with no cirrhosis, Group B of 12 chronic HCV patients withestablished cirrhosis and 12 healthy controls. Patients were treated by Pegylated INF -2a (180 g forgroup A and 130 g for group B) once weekly & 1200 mg Ribavirin/ day in two doses. Tested parametershave been done by ELISA method before and after treatment for group A, group B and control group.Results: end of treatment response (ETR) and sustained virological response (SVR) were 73.817% and61.91% for group A, and 58.33% and 33.33% for group B respectively. Serum IL-1ra was increased aftertreatment but this increase was not significant (P>0.05). There was a significant increase of serum insulin(P