Side effects of antiviral therapy in patients with chronic hepatitis C infection

Introduction. Chronic hepatitis C currently represents a global health problem, which is expected to be reduced by pegylated-interferon and ribavirin therapy. Material and Methods. We examined 88 patients with chronic hepatitis C, divided into three groups according to their comorbidity: the patients without comorbidity were in group I, group II included the patients on dialysis, and group III included the patients with hemophilia. Results. A significant difference was found in the percentage of achieved sustained virological response between the patients on dialysis and other patients, p<0.05. Having analyzed the therapy adverse effects, we observed a significantly higher decrease of erythrocytes count, hemoglobin and hematocrit levels in dialysis patients compared to others (p<0.01). The patients on hemodialysis predominantly had anemia and leukopenia, while thrombocytopenia was equally present in all groups. The dominant clinical side effect was flu-like syndrome, present in more than a half of patients. Discussion. The therapy positive effect is usually accompanied with adverse effects. The lowest therapeutic response was recorded in group II, due to the virus genotype 1. A significant decrease in hematological parameters was determined in all patients. The most common clinical adverse effect was flu-like syndrome, later manifestations included: weight loss, alopecia, insomnia and irritability. Side effects like psychosis, thyroid gland dysfunction or psoriasis were not recorded. Conclusion. A significant decrease in the value of all these hematological parameters was found in all groups of patients. Clinical side effects were present in 60% of patients. Side effects did not lead to discontinuation of therapy, but only to modification of drug doses.

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Impact of Direct Acting Antivirals therapy on metabolic profiles and adiponectin serum level in Egyptian patients with chronic hepatitis C infection

QJM ◽

10.1093/qjmed/hcab100.124 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed Lotfy Fahmy Abd Elmeged ◽

Sameh Mohamed Fahim Ghaly ◽

Osama Ashraf Ahmed ◽

Ahmed Samir Abohalima ◽

Ahmed Samir Allam ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Lipid Profile ◽

Chronic Hepatitis C ◽

Adiponectin Level ◽

Fasting Insulin ◽

Group I ◽

Significant Difference ◽

Before And After ◽

Group Ii

Abstract Background and Objectives Hepatitis C Virus (HCV) infection is a major global health challenge. Chronic hepatitis C viral infection is associated with wide metabolic disarrangements. HCV interacts with lipid metabolism leading to steatosis, causing wide adipocytokines changes and impairs glucose metabolism leading to increased prevalence of insulin resistance (IR) and type 2 diabetes. Several oral anti-HCV drugs (direct acting antivirals; DAAs) have been developed over the last several years. Now, HCV can be eliminated from the infected host within 12 weeks of DAA combination therapy. As, there is limited data on the effects of DAA therapy on metabolic profiles, lipid profile and adiponectin level. Hence, this study was carried out to evaluate the Impact of Direct Acting Antivirals therapy on metabolic profiles and adiponectin serum level in Egyptian patients with chronic hepatitis C infection. Methods This study was performed on 100 patients who have chronic infection with hepatitis C, patients were divided into two groups, Group I was 50 patients were treated with (Sofosbuvir/Daclatasvir/Ribavirin) for 3 months. Group II was 50 patients were treated with (Ombitasvir, Paritaprevir, Ritonavir/Ribavirin) for 3 months. With follow up changes were occurred in Fasting Lipid profile (total cholesterol, triglyceride, HDL and LDL), metabolic profile (fasting blood sugar, Fasting Insulin, HOMA-IR and HBA1C) and Serum adiponectin level before and after end of treatment. Results One hundred patients met inclusion criteria were reviewed, (56%) were males in group I while (46%) were males in group I, Mean age in group I was 47.4 ± 5.3 years while in group II was 43.2 ± 6.6 years, statistical analysis of data showed significant difference in the lipid profile in group I before and after treatment .As, we found significant reduction in serum triglycerides after treatment (113.2 ± 22.9 mg/dL vs 105.6 ± 23.2 mg/dL, P < 0.001) and a significant elevation of serum Total Cholesterol, LDL and HDL after treatment (TC: 153.2 ± 20.1 mg/dL vs 174.1 ± 19 mg/dL, P < 0.001, LDL: 74.7 ± 9.9 mg/dL vs 93.3 ± 12 mg/dL, P < 0.001, HDL: 54.6 ± 10.1 mg/dL vs 57.2 ± 10.3 mg/dL, P 0.010) But in group II there was no significant difference in the lipid profile before and after treatment, Also, We found significant reduction in fasting insulin, HOMAIR and HBA1C after treatment in group I (Fasting Insulin: 11.4 ± 3.3 (uU/L)/ml vs 9.7 ± 2.2 (uU/L)/ml, P < 0.001, HOMA-IR: 2.7 ± 0.9 vs 2.2 ± 0.6, P < 0.001, HBA1C: 5.6 ± 0.4 vs 5.4 ± 0.3, P 0.003) But in group II there was no significant difference in fasting insulin, HOMA-IR and HBA1C before and after treatment. Also, we found that there was no significant changes in the serum adiponectin level in the both group before and after treatment. Conclusion Eradication of chronic hepatitis C viral infection with DAAs may affect the lipid and the metabolic profile of patients after the end of treatment according to the type of DAAs used in the treatment and according to the stage of the liver disease of patients. But not affect the serum Adiponectin level.

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Treatment of Chronic Hepatitis C Virus Using Direct Acting Antivirals in Geriatric Egyptian Patients

Recent Advances in Anti-Infective Drug Discovery ◽

10.2174/2772434416666210716123909 ◽

2021 ◽

Vol 16 ◽

Author(s):

Mahmoud Elkadeem ◽

Shoman Rabeei Shoman

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Geriatric Patients ◽

Direct Acting Antivirals ◽

Group I ◽

Significant Difference ◽

Chronic Hepatitis C Virus ◽

Direct Acting

Background & Aims: There is a high proportion of geriatric patients who acquired chronic hepatitis C virus infection. There is a shortage of evidence-based data as regards direct-acting antivirals in this group of patients. The aim was to assess the safety, efficacy, and tolerability of direct-acting antiviral drugs in Egyptian geriatric patients. Methods: This prospective study was performed on 177 patients with chronic hepatitis C and administrated different regimens of direct-acting antivirals. Patients were divided into two groups: Group I: patients below 65 years old (N = 143), and Group II: patients > 65 years old (N = 34). Pretreatment history taking, baseline characteristics, and investigations were done for both groups. Follow-up was made to detect treatment efficacy and adverse effects. Results: The geriatric group was found to have more comorbidities (diabetes mellitus, hypertension, and cardiomyopathy), also liver cirrhosis. Minor adverse effects in both groups without significant difference included fatigue, insomnia, headache, and dizziness. Vomiting, diarrhea, and skin rash occurred in group II more than group I. Leucopenia, thrombocytopenia, jaundice, and significant anemia occurred without substantial difference between both groups. Eighteen patients (25%) of 72 patients who took ribavirin had to reduce the ribavirin dose or stop it. The overall treatment response in the entire study was 97.7%, without significant difference between both groups. Conclusion: Direct-acting antivirals are recommended regardless the age. These drugs are effective and tolerable in elderly patients. Attention to other comorbidities, drug-drug interactions, and follow-up is recommended.

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Clinical and pathogenetic aspects of the side effects of chronic viral hepatitis C alpha-interferon antiviral therapy

Kazan medical journal ◽

10.17816/kmj2006 ◽

2014 ◽

Vol 95 (6) ◽

pp. 924-928

Author(s):

G Z Aripkhodzhaeva

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Side Effects ◽

Adverse Effects ◽

Chronic Hepatitis C ◽

Antioxidant System ◽

Antiviral Treatment ◽

Alpha Interferon ◽

Diene Conjugates

Aim. To investigate the relation of prooxidant and antioxidant systems with adverse effects of antiviral alpha interferon treatment in chronic hepatitis C. Methods. The study included 67 patients with chronic hepatitis C aged 19 to 45 years [males - 28 (41.8%), females - 39 (58.2%)] who were receiving antiviral treatment. Prooxidant (diene ketones and diene conjugates, malon dialdehyde) and antioxidant (catalase, superoxide dismutase, glutathione and glutathione-dependent enzymes) systems indicators were measured. According to the severity of side effects, patients were distributed to two groups. The first group consisted of 19 (28.4%) patients with transient passing adverse effects, usually manifesting as short-term flu-like syndrome after the medication injection, lasting no longer than 2-3 weeks of treatment. The second group consisted of 48 patients (71.6%) with prolonged side effects, registered throughout the whole treatment period. Results: Flu-like syndrome with intense myalgia and asthenic syndrome were the most frequent side effects (89.5 and 83.3% of cases, respectively). Dyspepsia, psychopathy and arthralgia were less common (79.2, 72.9 and 68.7%, respectively). Over than a half of the patients lost weight (7-9 kg compared to baseline weight), and also had alopecia and autoimmune thyroiditis. Most of the patients could not tolerate the treatment, 33 (49.2%) patients aborted the treatment. In patients with long-term side effects, low baseline levels of glutathione reductase, glutathione peroxidase, glutathione transferase were revealed (p 0.05). Patients with long-term side effects of antiviral treatment preserved high levels (p 0.05) of diene ketones and diene conjugates and statistically significant (p 0.05) suppression of antioxidant system at the 10-12 weeks of treatment. Conclusion. Examined patients with chronic hepatitis C had diverse activity of antioxidant system. Long-term side effects were seen in patients with low levels of parameters of antioxidant protection at the baseline.

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