SUMMARY AND CONCLUSIONNon histological markers of hepatic fibrosis in liver disease are still holly grill in hepatology. Currently liver biopsy is the gold standard for diagnosis and treatment of liver disease and required speciment to be more than 20 mm in length and contain 11 portal tract to be able to assess stages and grades of hepatic fibrosis probably. Histological examination of liver tissue biopsy, is recommended prior to the initiation of antiviral therapy (EASL International Consensus Conference on hepatitis C, 1999). It is vital for monitoring fibrosis progression. Unfortunately, this procedure is invasive, prone to complications, including hemorrhage and death (Poynard et al., 2000) and has a high risk of sampling error (Maharaj et al., 1986).In this study, 4 biochemical markers of hepatic fibrosis (alpha 2 macroglobulin, haptoglobin, apolipoprotien A1, GGT) used together with routine fiver function test were of an excellent predictor of hepatic fibrosis when compared with liver biopsy.This biochemical markers in prediction of hepatic fibrosis mostly in stage 2, 3, 4 according to METAVIR scoring system.This fact increase the need for non histological markers for hepatic fibrosis alone or in combination with liver biopsy. Biochemical markers for liver fibrosis and necroinflammatory features are an alternative to liver biopsy, in patients with chronic hepatitis C (Poynard et al., 2002).For detection of liver fibrosis by non invasive technique study of some serum biochemical markers in patients infected with HCV.For this aim, thirty patients with chronic hepatitis C infection were studied and their results were compared with that of 20 control subjects.All the studied patients and controls were subjected to:1- Complete clinical examination with full history taking.2- Abdominal ultrasound for assessment of chronic liver condition.3- Complete blood picture.4- Liver function tests including bilIrubin, albumin, AST, ALT, alkaline phosphatase and GGT.5- Prothrombin time.6- Detection of HCV antibodies by ELISA.7- Detection of HCV RNA by PCR for patients only.8- Serum alpha 2 macroglobulin, apolipoprotein A1, haptoglobin by immune diffusion methods.9- Liver biopsy for detection of fibrosis and necroinflammatory activity for HCV-RNA positive.The results of this study show the following:• Highly significant reduction in platelets number of the patients.• Highly significant reduction in haemoglobin concentration of the patients.• Significant changes in liver function test with the degree of fibrosis in form of increase of liver enzyme (ALT, AST), serum bilirubin, serum alkaline phosphatase, serum GGT and decrease in serum albumin.• Highly significant prolongation in PT of the patients.• Highly significant decrease in haptoglobin in patients with fibrosis.• Highly significant decrease in apolipoprotein A1 of the patients and among the stages of liver fibrosis.• Highly significant increase in alpha 2 macroglobulin of the patients, and good correlation with fibrosis.