Fouad Rabab, El-Akel Wafaa, ElMakhzangy Hesham, Lithy Rania M, Sherif Mirella, Fateen Mohamed, Hassany Mohamed, Abdel-Razek Wael, Doss Wahid
Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Arab J Gastroenterol. 2025 Feb;26(1):78-83. doi: 10.1016/j.ajg.2024.11.004. Epub 2025 Jan 27.
Hepatitis C virus (HCV) infection is a significant problem in Egypt, as it is associated with various hematological disorders, both benign and malignant. In Egypt, direct-acting antivirals (DAAs) serve as the principal therapy for HCV to achieve a sustained virological response (SVR). This study investigated the effects of sofosbuvir (SOF) and daclatasvir (DCV) on HCV patients with benign blood index abnormalities and examined the correlation between these abnormalities and SVR.
Data were obtained from 59,069 enrolled patients who were treatment-naïve and met the eligibility criteria for therapy as per the standards of Egypt's National Committee for Control of Viral Hepatitis (NCCVH). The patients adhered to the SOF and DCV therapy protocol.
The predominant hematological abnormality was thrombocytopenia, followed by leukopenia and anemia. Non-SVR was significantly correlated with the existence of one or more baseline cytopenias. The primary predictors of treatment failure were male gender, elevated Fib-4 score, and baseline thrombocytopenia. Despite the low incidence of cytopenia among patients after therapy, non-SVR was seen in instances of anemia.
Hematological problems often occur in HCV patients both before and after SOF and DCV treatment. Treatment failure was associated with the presence of one or more baseline cytopenias, as well as the development of anemia during treatment. Nonetheless, SOF and DCV are still safe to be used in the presence of cytopenia.
丙型肝炎病毒(HCV)感染在埃及是一个重大问题,因为它与各种良性和恶性血液系统疾病相关。在埃及,直接抗病毒药物(DAAs)是治疗HCV以实现持续病毒学应答(SVR)的主要疗法。本研究调查了索磷布韦(SOF)和达卡他韦(DCV)对伴有良性血液指标异常的HCV患者的影响,并研究了这些异常与SVR之间的相关性。
数据来自59069名初治患者,这些患者符合埃及国家病毒性肝炎控制委员会(NCCVH)制定的治疗资格标准。患者遵循SOF和DCV治疗方案。
主要的血液学异常是血小板减少,其次是白细胞减少和贫血。未实现SVR与存在一种或多种基线血细胞减少显著相关。治疗失败的主要预测因素是男性、Fib-4评分升高和基线血小板减少。尽管治疗后患者血细胞减少的发生率较低,但在出现贫血的情况下仍可见未实现SVR的情况。
在SOF和DCV治疗前及治疗后的HCV患者中经常出现血液学问题。治疗失败与存在一种或多种基线血细胞减少以及治疗期间贫血的发生有关。尽管如此,在存在血细胞减少的情况下使用SOF和DCV仍然是安全的。