Efficacy of new direct acting antiviral-DAA (sofosbuvir) therapy in the management of rheumatological extrahepatic manifestations of HCV / Shaimaa Ahmed Saad ; Supervised Amira Abdelsabour Shahin , Hania Salah Zayed , Mohamed Said Abdelaziz

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Rheumatology and Rehabilitation

Background: The HCV epidemic is particularly devastating in Egypt as Egypt has the highest HCV prevalence in the world (14.7%). According to Health Issues Survey in 2015; 7% of Egyptians are chronic active hepatitis C patients. Chronic HCV infection primarily affects the liver with an array of extrahepatic manifestations, involving different organ systems leading to the concept of systemic HCV infection these manifestations include autoimmune phenomena and frank autoimmune and/or rheumatic diseases and may dominate its course. Objectives: This study aimed to assess the efficacy and safety of the new Direct Acting Antiviral drug Sofosbuvir in management of HCV related rheumatologic extrahepatic manifestations Arthropathy and Vasculitis. Patients and Methods: Thirty HCV patients with rheumatologic extrahepatic manifestation were included in this study. They received Sofosbuvir-based therapy as dual or triple regimen (Group A). The data of fifteen patients received the standard combined Peg-Interferon and RBV (Group B) were included as controls. The prospective data of the patients and the retrospective data of the controls were considered for analysis at baseline, at the end of treatment, 12weeks and 24weeks after termination of treatment.Results: On comparing the four visits in Group A with the four visits in Group B, statistically significant difference was found in VAS and in TJC and in modified DAS28 in all visits (P<0.05), however the difference in FAS between both groups in all visits was statistically insignificant. There was a statistically significant improvement in BVAS 2003(P<0.05) in the four visits

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