Serum MicroRNAs as predictors for fibrosis progression and response to direct‐acting antivirals treatment in hepatitis C virus genotype‐4 Egyptian patients

Background MicroRNA (miRNAs) are small non‐coding molecules that play an important role in hepatitis C virus (HCV) replication and liver diseases progression. The current study aimed to evaluate serum miRNAs as potential biomarkers for diagnosis, monitoring of fibrosis progression and prediction of responses to direct‐acting antivirals (sofosbuvir + daclatasvir + ribavirin) in HCV genotype‐4 patients. Methods The serum levels of four miRNAs (miRNA‐21, 199, 448 and 181c) were assessed in 150 HCV patients and 50 healthy controls using quantitative real‐time PCR. The diagnostic accuracy was determined using receiver operating characteristic (ROC) curve. Results The four studied miRNAs showed significant upregulation in HCV patients compared with controls. There were significant upregulation of MiR‐199 and significant downregulation of miR‐448 in late stages of fibrosis with high diagnostic accuracy (area under the curve “AUC” = 0.989%; P .001), respectively. Regarding response to treatment, only miR‐199 showed a significant upregulation in non‐responder patients with high diagnostic accuracy (AUC = 0.968; P