Pulmonary complications of antiviral drugs (Sofosbuvir and Daclatasvir) used in treatment of patients with chronic hepatitis C virus

Abstract

Background: Egypt has one of the highest hepatitis C virus (HCV) prevalence rates in the world, which led the government to strive to control it. The national guidelines for chronic HCV treatment had been modified to be interferon-free regimens by giving, the pan-genotypic direct acting antiviral agents (DAAs), sofosbuvir plus daclatasvir with or without ribavirin regimen. The aim of the study was the evaluation of the development of any considerable pulmonary complications among Egyptian patients receiving the combination of sofosbuvir plus daclatasvir for the treatment of chronic HCV infection. Patients and Methods: The study included fifty patients with chronic HCV who were planned to be treated with sofosbuvir plus daclatasvir regimen. They were followed up during the course of the treatment to report and diagnose any developed respiratory symptoms, with two main stations of assessment (pre-and post-treatment), to compare between both outcomes. Results: Nine patients (18%) developed respiratory symptoms during this regimen, in the form of cough (16%), sputum production (6%), dyspnea (6%), fever (6%), and rhinorrhea (4%). Their diagnoses were; acute bronchitis (2 patients), flu-like symptoms (2 patients), cough due to gastro-esophageal-reflux-disease (1 patient), mild airway hyperresponsiveness (1 patient), community-acquired pneumonia (1 patient), community-acquired pneumonia with para-pneumonic effusion (1 patient) and idiopathic pleural effusion (1 patient). They were managed without discontinuation of the regimen. Conclusion: Sofosbuvir plus daclatasvir regimen was generally safe on the respiratory system, and some patients developed manageable nonserious respiratory events during the course of treatment.