Cardiac Safety of Direct Acting Antiviral Agents among Egyptian Patients with Chronic Hepatitis C Infection

Abstract

Background: Hepatitis C virus (HCV) is a major health problem in Egypt. Direct-actingantivirals (DAA) have markedly improved the treatment of HCV. However data regardingcardiovascular performance and safety are limited. The aim of our work was to assesscardiovascular performance and cardiac safety of direct acting antiviral agents in patients withchronic hepatitis C virus infection. Results: Our study was a prospective cohort involving 64 HCV patients treated with DAA for 3weeks. All patients performed surface electrocardiogram (ECG), stress ECG test and trans-thoracicechocardiography before and after treatment. The end point of this study was the development ofmajor adverse cardiovascular event (MACE).12% of the studied patients showedimprovedcardiovascular performance after successful treatment of HCV with DAA. Predictors of improvedcardiovascular performance included lower baseline alanine aminotransferase, lower baseline restingheart rate and higher maximum heart rate during exercise post treatment. DAA had no significanteffect on resting ECG or transthoracic-echocardiographic parameters. No major adversecardiovascular event or complication occurred during or 3 month after treatment.None of the enrolled patients developed any signs of ischemia. Conclusion: Direct acting antiviral agents were associated with an improvement incardiovascular performance and exercise related symptoms. DAA proved its cardiac safety inpatients with chronic hepatitis C virus infection receiving DAA