Objectives: To detect the correlation between the single nucleotide polymorphisms (SNPs) in MBOAT7 and PNPLA3 genes and hepatic fibrosis in hepatitis C virus (HCV) Egyptian patients, and to highlight the additive effect, if any, of MBOAT7 on the correlation of PNPLA3 polymorphism with liver fibrosis in HCV patients from Egypt. Methods: In this cross-sectional study, we recruited treatment-naïve patients with chronic HCV. The rs738409 (PNPLA3) and rs641738 (MBOAT7) polymorphisms were assessed by Real-Time PCR. We utilized the METAVIR‐Score to classify the degree of hepatic fibrosis and necroinflammatory activity.
Results: A total of 93 patients (mean age 42.72 ± 10.46; males = 49.5%) were included. Our analysis showed that 10.8% of the patients had GG genotype of the PNPLA3 gene and 46.2% had TT genotype of the MBOAT7 gene.  Compared to combined CC and GC genotypes, carriers of GG genotype in PNPLA3 gene were more likely to be males (p =0.041), have higher fibrosis grade (p =0.043), have higher serum creatinine (p < span style="text-decoration: line-through;">=0.036), higher TSH (p =0.017) and higher viral load (p =0.045). Notably, we found a significant association between TT genotype in MBOAT7 and advanced fibrosis only (but not with necroinflammation (p >0.05). Our multivariate analysis showed that the GG genotype in the PNPLA3 gene and TT genotype in the MBOAT7 gene were independent predictors of advanced fibrosis. Conclusion: PNPLA3 GG genotype and MBOAT7 TT genotype are independent predictors for hepatic fibrosis, and thus might be linked to faster disease progression.