As HCV is associated with many extra hepatic complications involving renal, articular, neuorologic, cutaneous and haemopoietic systems, several autoimmune phenomenon are observed in patients infected with HCV [39,40], decline of Hb level with increase of viral load in genotype 4 may lead to autoimmune haemolytic anemia (AIHA) that can contribute to enhance the liver cirrhosis in genotype 4 as the patients with HCV related AIHA have higher prevalence of cirrhosis [41]. This evidence concerns the gene GSTM1 and cirrhosis of liver.