Musculoskeletal Manifestations among Egyptian HCV Patients Receiving Direct Antivirals (DAAS) Therapy

Author(s): Marwa A Besar, Adel I Abd El Salam, Asmaa F Enin, Doaa A Anter

Introduction: Hepatitis C is a worldwide problem; the treatment of chronic HCV has been revolutionized with the introduction of the oral Direct-Acting Antiviral (DAA) drugs. The efficacy in eradication of extrahepatic and hepatic manifestation leads to its widely spread of these medications, but there is musculoskeletal side effect reported with its use.

Objectives: Assess musculoskeletal manifestation in HCV patients receiving Direct Antivirals Therapy (DAATs) attending Rheumatology & Immunology Unit in internal medicine department in Mansoura university Hospital.

Result: Majority of studied patients (n=200) were 64% females and 36% were male. The most frequent involved joint was the knee 55% (110), while the least affected joint was the wrist 6% (12) and the shoulder joint 8%. It was observed that bone pain (71.1%) especially at shoulder joint (64.3%) and back (60.7%) were associated with Sofosbuvir+ Daclatasvir but were statistically insignificant. Arthralgia was presenting manifestation in 63% with patients received Sofosbuvir +Daclatasvir and dominated in the wrist joint (66.7%), knee joint (65.5%), shoulder joint (62.5%) but it was statistically insignificant. Back pain was evident in patients treated by DAAs for 12 weeks (27.7%) than those received it for 24 weeks (11.8%) and it was statistically significant p* = 0.050.

Conclusion: Musculoskeletal disorders reported mainly with sofosbuvir and daclatasvir especially for 12-week duration and the most affected age group (more than 55year).