The Safety of Direct-Acting Antiviral Treatment for Hepatitis C Virus in Egyptian Patients With Ischemic Heart Disease and Mildly Impaired Systolic Function

Background: Hepatitis C virus (HCV) infection is considered a public health problem in Egypt. The use of direct-acting antivirals (DAAs) in patients infected with HCV has been shown to be effective. The cardiac safety of these antivirals remains uncertain, however. This study aimed to assess the safety of the use of DAAs in patients suffering from ischemic heart disease (IHD) with mildly impaired systolic function. Method: This prospective cohort study was performed on 200 patients with chronic HCV infection scheduled for DAA use. The patients were divided into 2 groups: Group I comprised 96 patients with IHD and mildly impaired systolic function and Group II comprised 104 patients without IHD and with normal left ventricular ejection fractions. Both groups received sofosbuvir (400 mg) and daclatasvir (60 mg) daily for 12 weeks. Electrocardiography and echocardiography were performed prior to the start, during, and after 12 weeks of treatment. Result: At the end of the treatment period, no changes were observed in the patients’ cardiac symptoms and signs. No significant changes were also detected in electrocardiographic parameters, including the QTc interval in Group I (P =0.60) or Group II (P =0.63). Moreover, no changes were recorded in both groups regarding left ventricular systolic and diastolic functions (ie, the dimension, the ejection fraction, the transmitral E/A ratio, the E/E’ ratio, and the deceleration time), the tricuspid annular plane systolic excursion, right ventricular systolic pressure, and the mean pulmonary artery pressure. Conclusions: The use of DAAs to treat Egyptian patients infected with HCV was safe in those suffering from IHD with mildly impaired systolic function. The treatment with DAAs exerted no effects on the QTc interval and the function of the left and right ventricles.