Possible deleterious effect of viral hepatitis C therapy in the form of Sofosbuvir and Daclatasvir on the extent of atherosclerotic peripheral arterial disease

Abstract

eripheral artery disease (PAD) broadly encompass the vascular diseases caused primarily by atherosclerosis and thromboembolic pathophysiologic processes that alter the normal structure and function of the aorta, its visceral arterial branches, and the arteries of the lower extremity. PAD is the preferred clinical term and should be used to denote stenotic, occlusive and aneurysmal diseases of the aorta and its branch arteries, exclusive of the coronary arteries. It is estimated that more than 200 million people have PAD worldwide, with a spectrum of symptoms from none to severe. HCV infection is one of the main causes of chronic liver disease worldwide. The long-term impact of HCV infection is highly variable, ranging from minimal histological changes to extensive fibrosis and cirrhosis with or without hepatocellular carcinoma (HCC). Egypt has the highest HCV prevalence in the world, it estimated HCV prevalence among the 15–59 years age group to be 14.7%. This unparalleled level of exposure to this infection appears to reflect a national level epidemic. Today, HCV infection and its complications are among the leading public health challenges in Egypt. Sofosbuvir, the first nonprotease inhibitor direct antiviral to be approved (on December 6, 2013), is a uridine nucleoside polymerase inhibitor with one of the best profiles among the new oral hepatitis C antiviral agents being developed. It is very