Effect of Chronic Hepatitis C Virus Treatment by Combination Therapy on Cardiovascular System

Abstract

BACKGROUNDThe prevalence of hepatitis C virus (HCV) in Egypt is quite high, and the combined oral direct-acting antiviral agents (DAAs) may have impressive results.OBJECTIVETo assess the cardiovascular effects of DAAs in patients with HCV.METHODSA total of 170 patients with HCV were divided into 2 groups: first group (100 patients) received triple combination therapy (pegylated interferon alfa, sofosbuvir, and ribavirin, whereas the second group (70 patients) received dual combination therapy (sofosbuvir and simeprevir). Group 1 patients were followed up for 1 year more than 3 visits, whereas group 2 patients were followed up for 6 months more than 2 visits; and the end point of the study was the development of a major cardiovascular event (eg, 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.RESULTSNo significant differences were found between the 2 study groups regarding demographic criteria. None of the both group patients had developed any major cardiac event. No significant changes were observed regarding ST-T wave abnormalities, arrhythmias, or QT interval. None of the both group patients developed echocardiographic regional wall motion abnormalities at baseline or at study end. Systolic function parameters showed minute nonsignificant changes over study visits. Diastolic function parameters showed nonsignificant changes between baseline and 6-month and 12-month visits.CONCLUSIONSThe DAAs used in combination regimen with interferon or used orally in combination do not significantly affect the cardio-vascular system.

The Safety of The Directly Acting Antiviral Treatment For Hepatitis C Virus According To The Egyptian National Program Protocol In Patients With Midrange Ejection Fraction

“…D’Agostino et al [ 18 ] found that HCV infection surges cardiovascular hazards, including heart failure. Reda et al [ 19 ] found that DAAs did not cause EF changes or new RWMAs in patients with normal baseline EF [ 14 ]. Our study found that DAAs in patients with midrange LVEF did not worsen their NYHA functional Class or EF by the end of treatment after three months.…”

Impact of DAA Treatment on Cardiovascular Disease Risk in Chronic HCV Infection: An Update

“…DAAs treatment utilized in a national Egyptian study for HCV infection treatment in patients with and without liver cirrhosis, did not cause any change in QTc interval. According to the study reported by Biomy et al, the cardiovascular impact of DAAs was assessed in 170 patients with HCV, and no arrhythmias were noted ( Biomy et al, 2017 ). A more recent study on DAAs in Egyptian patients also showed a benign on cardiovascular safety profile ( Ibrahim et al, 2020 ).…”

Assessing the impact of a combination of sofosbuvir and daclatasvir treatment for hepatitis C virus infection on heart rate, rhythm and heart rate variability using 24-hour ECG monitoring

“…It included 170 patients with HCV infection: 100 patients received a triple combination therapy of pegylated IFN alfa, sofosbuvir, and ribavirin, while 70 patients received a dual combination therapy of sofosbuvir and simeprevir. No arrhythmias or changes in QTc interval were observed in any patients before and after therapy using the 12-lead surface ECG [16].…”