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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objective To evaluate the role of direct-acting antiviral (DAA) agents used for treatment of hepatitis C virus (HCV) in diabetic Egyptian patients. Background There was a revolutionary reduction HCV epidemic in Egypt. Combinations of DAAs were reported to show high rates of sustained virological response (SVR) and pan-genotypic clinical efficacy in HCV genotypes. Patients and methods A prospective study was conducted on 200 consecutive patients with chronic HCV infection (100 diabetic and 100 nondiabetic) who attended the outpatient clinics of National Hepatology and Tropical Medicine Research Institute and received sofosbuvir plus daclatasvir with ribavirin for 12 and 24 weeks according to HCV treatment protocol issued by the National Committee for Control of Viral Hepatitis. All investigations were done before and after treatment. Results There was no significant difference between both groups regarding rapid virological response (P = 0.226) and SVR (P = 0.106). Overall, 24% of patients developed adverse effects during treatment and 76 (76%) patients were free in the diabetic group, whereas in the nondiabetic group, only eight patients developed adverse effects during treatment and 92 (92%) patients were free. So, the diabetic group had significantly higher adverse effects than the nondiabetic group (P = 0.005). Conclusion There was no significant difference between both groups regarding rapid virological response and SVR. Improvement of glycemic control with DAAs was seen more in younger patients without family history of type 2 diabetes mellitus and short duration of diabetes mellitus. DAAs have proven to be safe and effective. DAAs are well suited for nearly all infected patients, and many countries worldwide have taken on initial treatment scale-up strategies.

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