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Ocular comorbidities with direct-acting antiviral treatment for chronic hepatitis C virus (HCV) patients

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Abstract

Purpose

The aim of this study is to detect the incidence and nature of ocular complications encountered in chronic hepatitis C virus (HCV) patients treated with direct-acting antiviral drugs.

Methods

This study is a prospective follow-up study on 200 chronic HCV patients attending the Outpatient Hepatology Clinic of National Liver Institute who were indicated for direct-acting antiviral treatment (sofosbuvir, daclatasvir and ribavirin) in the period between January 2017 and December 2017 and referred to the Department of Ophthalmology of Menoufia University hospitals where full ophthalmological examinations were done at the first visit before the treatment, the second visit at the end of the treatment (3 months) and the third visit 3 months later (6 months). Follow-up for those patients was done by slit-lamp examination, IOP measurement by applanation tonometer, colored fundus photographs, fluorescein fundus angiography (FFA), optical coherence tomography.

Results

Patients who received direct-acting antiviral therapy showed no ocular complications throughout the 6-month period of follow-up. Besides, BCVA and C/D ratio did not show any changes with no statistically significant differences between three visits. No signs of uveitis appeared in patients prescribed to the therapy protocols. Also, FFA did not show any retinal vascular changes. However, two cases of subconjunctival hemorrhage were observed with triple therapy.

Conclusion

Direct-acting antiviral treatment including sofosbuvir, daclatasvir and ribavirin appears to be safe and shows no detectable intraocular complications in the six-month follow-up period, and routine ophthalmic follow-up seems to be less required than in older anti-HCV medications.

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References

  1. Shepard CW, Finelli L, Alter MJ (2005) Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 5(9):558–567

    Article  PubMed  Google Scholar 

  2. Wanis H (2014) HCV treatment in Egypt—why cost remains a challenge? Egyptian initiative for personal rights, Cairo, Egypt, pp 1–4. https://eipr.org/en/publications/hepatitis-c-treatment-egypt-why-cost-remains-challenge. Accessed on 27 Aug 2018

  3. Waked I, Doss W, El-Sayed M (2014) The current and future disease burden of chronic hepatitis C virus infection in Egypt. Arab J Gastroenterol 15(2):45–52

    Article  PubMed  Google Scholar 

  4. Lawitz E, Mangia A, Wyles D, Rodriguez-Torres M, Hassanein T, Gordon SC, Schultz M, Davis MN et al (2013) Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med 368(20):1878–1887

    Article  CAS  PubMed  Google Scholar 

  5. Jacobson I, Gordon S, Kowdley K, Yoshida EM, Rodriguez-Torres M, Sulkowski MS, Shiffman ML, Lawitz E et al (2013) Sofosbuvir for hepatitis C genotype 2 or 3 in patients without treatment options. N Engl J Med 368(20):1867–1877

    Article  CAS  PubMed  Google Scholar 

  6. American Association for the Study of Liver Diseases and the Infectious Diseases. Society of America Recommendations for testing, managing, and treating hepatitis C. https://www.hcvguidelines.org/. Accessed on 27 Aug 2018

  7. European Association for the Study of the Liver (2014) EASL clinical practice guidelines: management of hepatitis C virus infection. J Hepatol 63:392–420

    Google Scholar 

  8. Fodor M, Nagy V, Berta A, Tornai I, Pfliegler G (2008) Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy. Eur J Ophthalmol 18:313–815

    Article  CAS  PubMed  Google Scholar 

  9. Misiuk-Hojło M, Michałowska M, Banach I (2007) Ocular manifestations during hepatitis C infection. Przegl Epidemiol 61:545–550

    PubMed  Google Scholar 

  10. Hayasaka S, Fujii M, Yamamoto Y, Noda S, Kurome H, Sasaki M (1995) Retinopathy and subconjunctival haemorrhage in patients with chronic viral hepatitis receiving interferon alfa. Br J Ophthalmol 79:150–152

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Egyptian Ministry of Health Annual Report (2007). Ministry of Health and Population website. https://www.mohp.gov.eg/. Accessed on 27 Aug 2018

  12. World Health Organization (1997) Hepatitis C. Wkly Epidemiol Rec 72:65–72

    Google Scholar 

  13. Dusheiko G (1997) Side effects of alpha interferon in chronic hepatitis C. Hepatology 26(3 Suppl 1):112S–121S

    Article  CAS  PubMed  Google Scholar 

  14. Ikebe T, Nakatsuka K, Goto M, Sakai Y et al (1990) A case of retinopathy induced by intravenous administration of interferon. Folia Ophthalmol Jpn 41:2291–2296

    Google Scholar 

  15. Tokai R, Ikeda T, Miyaura T et al (2001) Interferon associated retinopathy and cystoid macular edema. Arch Ophthalmol 119(7):1077–1079

    CAS  PubMed  Google Scholar 

  16. Guyer DR, Tiedeman J, Yannuzzi LA (1993) Interferon-associated retinopathy. Arch Ophthalmol 111(3):350–356

    Article  CAS  PubMed  Google Scholar 

  17. Chin-loy K, Galaydh F, Shaikh S (2016) Correction: retinopathy and uveitis associated with sofosbuvir therapy for chronic hepatitis C infection. Cureus 8(7):3

    Google Scholar 

  18. Sugano S, Suzuki T, Watanabe M (1998) Retinal complications and plasma C5a levels during interferon alpha therapy for chronic hepatitis C. Am J Gastroenterol 93(12):2441–2444

    Article  CAS  PubMed  Google Scholar 

  19. Sugano S, Yanagimoto M, Suzuki T (1994) Retinal complications with elevated circulatingplasma C5a associated with interferon-alpha therapy for chronic active hepatitis C. Am J Gastroenterol 89(11):2054–2056

    CAS  PubMed  Google Scholar 

  20. Raza A, Mittal S, Sood GK (2013) Interferon-associated retinopathy during the treatmentof chronic hepatitis C. J Viral Hepat. 20(9):593–599

    Article  CAS  PubMed  Google Scholar 

  21. Elgouhary SM, Said-Ahmed KE, Mowafy MA (2019) Anatomical and functional retinal complications of combined sofosbuvir and ribavirin therapy in patients with chronic hepatitis C virus. Ophthalmic Surg Lasers Imaging Retina 50(1):39–41

    Article  PubMed  Google Scholar 

  22. Vujosevic S, Tempesta D, Noventa F, Midena E, Sebastiani G (2012) Pegylated interferon-associated retinopathy is frequent in hepatitis C virus patients with hypertension and justifiesophthalmologic screening. Hepatology 56(2):455–463

    Article  CAS  PubMed  Google Scholar 

  23. Kim ET, Kim LH, Lee JI, Chin HS (2009) Retinopathy in hepatitis C patients due to combination therapy with pegylated interferon and ribavirin. Jpn J Ophthalmol 53(6):598–602

    Article  CAS  PubMed  Google Scholar 

  24. Panetta JD, Gilani N (2009) Interferon-induced retinopathy and its risk in patients with diabetesand hypertension undergoing treatment for chronic hepatitis C virus infection. Aliment Pharmacol Ther 30(6):597–602

    Article  CAS  PubMed  Google Scholar 

  25. Jain K, Lam WC, Waheeb S (2001) Retinopathy in chronichepatitis C patients during interferon treatment with ribavirin. Br JOphthalmol 85:1171–1173

    Article  CAS  Google Scholar 

  26. Nagaoka T, Sato E, Takahashi A, Yokohama S, Yoshida A (2007) Retinal circulatory changes associated with interferon induced retinopathy in patients with hepatitis C. Invest Ophthalmol Vis Sci 48:368–375

    Article  PubMed  Google Scholar 

  27. d’Alteroche L, Majzoub S, Lecuyer AI, Delplace MP, Bacq Y (2006) Ophthalmologic side effects during alpha-interferontherapy for viral hepatitis. J Hepatol 44:56–61

    Article  PubMed  Google Scholar 

  28. Okuse C, Yotsuyanagi H, Nagase Y, Kobayashi Y, Yasuda K, Koike K, Iino S, Suzuki M et al (2006) Risk factors for retinopathy associated with interferon alpha-2b and ribavirin combination therapy in patients with chronic hepatitis C. World J Gastroenterol 12:3756–3759

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Schulman JA, Liang C, Kooragayala LM, King J (2003) Posterior segment complications in patients with hepatitis C treated with interferon and ribavirin. Ophthalmology 110:437–442

    Article  PubMed  Google Scholar 

  30. Salman AG (2016) Ocular surface changes with Sofosbuvir in Egyptian patients with hepatitis C virus infection. Cornea 35(3):323–328

    Article  PubMed  Google Scholar 

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Correspondence to Mohamed Samy Abd Elaziz.

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Abd Elaziz, M.S., Nada, A.S.E., ElSayed, S.H. et al. Ocular comorbidities with direct-acting antiviral treatment for chronic hepatitis C virus (HCV) patients. Int Ophthalmol 40, 1245–1251 (2020). https://doi.org/10.1007/s10792-020-01290-y

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