Cardiovascular Effects of Oral Antiviral Treatment for Non-Cardiac HCV Patients

Abstract

Background: The prevalence of hepatitis C virus (HCV) in Egypt is quite high, and the combined oral direct-acting antiviral agents (DAAs) may have impressive results.Objectives: To assess the cardiovascular effects of oral antiviral treatment in non-cardiac HCV patients. Paitents and Methods:The study enrolled 100 patients with positive HCV who were enrolled for the new oral antiviral therapy in the form of Sofosbuvir and dclatsavir with or without ribavirin for 3 or 6 months. All patients on our study were subjected to follow up pre-and post-oral antiviral course, and the end point of the study was the development of a major cardiovascular event, e.g. congestive heart failure, echocardiographic evidence of left ventricular dysfunction, occurrence of significant arrhythmias, or acute coronary syndrome. The following parameters were accomplished: medical history and clinical examination, electrocardiogram, Echo-Doppler study, and laboratory investigations.Results: No significant differences were found between the patients regarding demographic criteria. None of the patients had developed any major cardiac event. No significant changes were observed regarding ST segment and T wave abnormalities, arrhythmias, or QT interval. None of patients developed echocardiographic regional wall motion abnormalities at baseline or at study end. Systolic function parameters showed minute non-significant changes over study visits. Diastolic function parameters showed non-significant changes between baseline and post oral antiviral course visit. Conclusion:The DAAs used in combination regimen didn't significantly affect the cardiovascular system.

Cardiovascular Risk Assessment after Sofosbuvir and Daclatasvir Regimen for Chronic Hepatitis C Virus Infection

“…The patients who were free of ectopics at baseline did not develop any significant arrhythmia, and there was no change in mean HR and no dynamic ST-T wave change. These results match well earlier studies (20)(21)(22)(23), which concluded that different DAA protocols had no major cardiac events.…”

Cardiac effects of direct anti-viral treatment in type II diabetic patients with hepatitis C infection

“…Regarding ECG changes, our results didn’t find any statistically significant effect of these drugs on different electrical parameter. This is supported by Allam et al [ 16 ] and Biomy et al [ 17 ] who noticed no statistically significant difference at heart rate, PR interval, QRS duration, QT interval, QTc interval, ST segment and T wave after treatment when compared to their values before treatment. In a recent study conducted in Egypt using 24-h ECG monitoring during treatment, they reported that in non-cardiac patients receiving no cardioactive medications, the combination of sofosbuvir and daclatasvir for the treatment of HCV infection has no effect on heart rate, rhythm, conductivity, or heart rate variability.…”

Evaluation of left ventricular function after sofosbuvir and daclatasvir regimen for chronic hepatitis C

“…12,17 Also, study findings as well as sampling, clinical and echo parameters match well with several studies. [18][19][20] Finally, recent studies have suggested that eradication with DAA regimens is not only safe and tolerable with no major cardiac events, but also significantly reduces cardiovascular adverse events and overall mortality. 21,22 The current study has its limitations.…”