A study of the cardiovascular effects of the direct acting anti-hepatitis C virus drugs by Cardiac Magnetic Resonance Imaging

Abstract

Chronic hepatitis C virus (HCV) infection is a global health problem. Egypt is among the top countries with highest HCV prevalence. The recent nationwide HCV screening program identified about 2.2 million HCV cases in Egypt. The introduction of the direct-acting antiviral (DAA) agents has revolutionized the HCV treatment. DAAs are highly effective in viral eradication compared to the previous treatment regimens, with better tolerability and fewer side effects. However, their cardiac safety remains debatable. We aimed to evaluate the cardiovascular (CV) effects and safety of the DAAs using cardiac magnetic resonance imaging (CMR). CMR provides better assessment of the biventricular volumes and functions compared to trans-thoracic echocardiography (TTE), with the added benefits of tissue characterization and detection of myocardial scarring and fibrosis via late gadolinium enhancement (LGE). This was a prospective observational study that included 24 treatment-naïve adult HCV patients recruited from the specialized virology clinics in Ain Shams university hospitals in the period between February and November 2019 receiving DAAs for HCV treatment according to the national protocol: sofosbuvir 400 mg daily with daclatasvir 60 mg daily for 12 weeks.