الفهرس | Only 14 pages are availabe for public view |
Abstract To this day, hepatitis C virus infection represents a global burden. The long term impact of HCV infection is highly variable, ranging from minimal effects to severe extrahepatic complications. In light of the advances in HCV therapy and treatment, monitoring is required to ensure safety of newly administrated regimens to patients. The aim of this study was to investigate possible cardiac effects of direct antiviral drugs on Egyptian HCV patients. Patients were divided into 2 groups: group 1: 45 noncirrhotic patients received treatment with Sofosbuvir + Daclatasvir for 12 weeks. group 2: 45 cirrhotic patients received treatment with Sofosbuvir + Daclatasvir + ribavirin for 12 weeks. All patient achieved sustained virologic response at week 12 after end of treatment (SVR12). All patients were assessed at week 0 (start of treatment) and week 12 after end of treatment(SVR 12) with laboratory studies including level of NT- Pro BNP, ultrasonography, Echocardiography. Also, study population was divided into 2 groups: Risky group: include patients above 50 yrs. old, Diabetics, prediabetics, obese (BMI >25 kg/m²), hypertensives, hyperlipidemia patients and smokers. Non- Risky group: include patients who have no CVD risk factors mentioned before. In this study statistical analysis of data showed no changes concerning either laboratory findings ‘liver functions Albumin, Bilirubin, INR & CBC’ or radiological findings ‘by abdominal ultra sound & fibro-scan’ in the study groups after clearing the virus at end of treatment, after 3 months post treatment except for AST and ALT. Liver enzymes including AST and ALT decreased significantly after achieving SVR. No significant changes in ECG parameters in both groups after achieving SVR were documented. NT-Pro BNP significantly increased after treatment with DAAs in both groups (cirrhotic and non-cirrhotic) and the same finding was noted in the risky group. Echocardiographic assessment of systolic and diastolic functions, dimensions and volumes of LV and RV revealed no significant changes in assessment parameters before and after treatment with DAAs in all studied groups. There was a negative correlation between change in Hb and change in NT-Pro BNP in cirrhotic group.We concluded that the treatments for DAAs used in combination regimens do not affect the cardiovascular system markedly. However, minor subclinical myocardial affection may occur especially in risky group for CVD. |