Effect of Direct Acting Antivirals on Cardiovascular Performance in Patients with Chronic Hepatitis C Virus Infection

Abstract

Background:Hepatitis C virus (HCV) is a major health problem in Egypt. Direct-acting antivirals (DAA) have markedly improved the treatment of HCV. However data regarding cardiovascular performance and safety are limited. The aim of our work was toassess cardiovascular performance andcardiac safety of direct acting antiviral agents in patients with chronic hepatitis C virus infection.

Results:Our study was a prospective cohort involving 64 HCV patients treated with DAA for 3 weeks. All patients performedsurface electrocardiogram (ECG), stress ECG test and trans-thoracic echocardiography before and after treatment. The end point of this study was the development of major adverse cardiovascular event (MACE).12% of the studied patients showed improved cardiovascular performance after successful treatment of HCV with DAA. Predictors of improved cardiovascular performance included lower baseline alanine aminotransferase, lower baseline resting heart rate and higher maximum heart rate during exercise post treatment. DAA had no significant effect on resting ECG or transthoracic-echocardiographic parameters. No major adverse cardiovascular 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 in cardiovascular performance and exercise related symptoms. DAA proved its cardiac safety in patients with chronic hepatitis C virus infection receiving DAA