The goal of this observational study was to study the occurrence of insulin resistance in hepatitis C virus infected children who were either thalassemic or survivors of childhood malignancy and its correlation to the HCV viral load and other metabolic factors.

The main question it aims to answer is:

1. Do children infected with Hepatitis C have a higher incidence of Insulin resistance compared to healthy controls of same age and gender?
2. Is Insulin resistance occurence affected by HCV viral load, blood transfusion frequency, or metabolic factors? Researchers will compare hepatitis c infected children who are either thalassemic or survivors of childhood malignant to healthy age and sex matched controls.

Participants will be subjected to:

• standardized Questionnaires,
• physical examination and
• laboratory investigations including liver functions (ALT, AST, Alkaline phosphatase), Prothrombin time, serum ferritin level, albumin, fasting glucose, fasting insulin level and Insulin resistance assessment by HOMA IR calculation.

Inclusion Criteria:

• hepatitis C virus ribonucleic acid (RNA) positive children, who were following up at the pediatric hematology and oncology clinic

Exclusion Criteria:

• patients with concurrent active hepatitis B virus infection (positive for hepatitis B surface antigen) or
• autoimmune hepatitis,
• primary biliary cirrhosis (PBC),
• sclerosing cholangitis,
• haemochromatosis,
• α1-antitrypsin deficiency,
• Wilson's disease,
• patients with obesity (BMI > 25), or
• Type 2 DM.

Patient group: Hepatitis C infected children and adolescents who are either thalassemia patients or survivors of childhood malignancy.

Control group: Age and sex matched healthy children and adolescents who are following up at pediatric outpatient clinic

this study enrolled patients before January 2019