الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic infection with hepatitis C virus (HCV) causes an estimated 500000 deaths per year and affects 130–170 million people, or 2–3% of the world’s population. Egypt is the country with the largest HCV epidemic worldwide. The GT distribution in Egypt in mainly GT-4, which is responsible for more than 90%of infection, with the remaining due to HCV GT-1. HCV infection has led to a major global health problem that requires widespread active intervention for its prevention and control. Many of those infected may ultimately progress to advanced liver disease and /or Hepatocellular Carcinoma (HCC). However, that outcome can be prevented by treatment, which is rapidly improving and offers the potential of a cure to more patients than has been previously possible. The primary goal of HCV therapy is to cure the infection. Treatment of HCV infection has undergone a dramatic change with the new direct acting antivirals (DAAs), by lowering treatment duration and side effects associated with prior pegaylated interferon (peg-INF) based treatment. Although these DAAs have greatly improved cure rates and reduced treatment durations. They have also brought with them greater cutaneous adverse events (AEs). So this study was aimed to assess and characterize the dermatological adverse events in CHC patients due to treatment with DAAs as well as detecting the relation between the skin lesions and response to therapy or patients characters. This observational prospective follow up study was conducted on 188 patients with CHC infection selected from the outpatient clinics of hepatology, Specialized Medical Hospital, Mansoura University from June 2019 to February 2020. Patients were divided into two groups according to the protocol of treatment: group (1): 138 patients who received SOF + DAC, group (2): 50 patients who received SOF + DAC+ RBV. The current study revealed that • SVR was100% in both treatment protocols. • The prevalence of dermatological adverse events was (5.3%) in 10 cases, 5 cases in SOF+DAC arm (3.6%) and 5 cases in SOF+DAC+RBV arm (10%). • There was statistically significantly higher FBG, AST, ALT, total serum bilirubin, INR, AFP, and proportion of shrunken liver and a statistically significantly lower TSH, WBCs count and platelet count in SOF+DAC+RBV arm vs SOF+DAC arm. While there were no significant difference in age, sex, residence, serum albumin, serum Creatinine, AST/ALT ratio, PCR, HB and proportion of enlarged spleen between both treatment arms. • Shrunken cirrhotic liver was statistically significantly higher in HCV patients with dermatological adverse events. HCV patients with shrunken liver have 11.2 times higher probability to develop dermatological adverse events when treated with DAAs than HCV patients without shrunken liver. There was no statistically significant difference in age and all laboratory parameters between those patients with and without dermatological adverse events. • Pruritus was the most frequent dermatological adverse events that observed in HCV patients treated with DAAs followed by skin rash either non-specific rash or lichen planus like rash, painful mouth ulcer, discoloration of libs and lastly dryness of mouth with fissuring of the tongue. • All dermatological adverse events improved over time within one or two months and disappeared completely at the end of treatment. • Fortunately, no one of HCV patients in the present study developed dermatological adverse events after stoppage of DAAs.