Cutaneous adverse events in patients with chronic hepatitis C during treatment with directly acting antiviral agents: a cohort study

Abstract

Background: Hepatitis C virus (HCV) affects approximately 2-2.5% of the global population. In Egypt, the prevalence was reported at 7% in 2015. Over recent years, new direct-acting antiviral (DAA) therapies have been developed. One of the most widely used regimens in Egypt for treating HCV infection is a combination of sofosbuvir and daclatasvir. However, there is still a limited understanding of the potential dermatological side effects associated with these medications.
Objective: This study aimed to evaluate the frequency and clinical manifestations of cutaneous adverse reactions in patients undergoing treatment with direct-acting antiviral drugs.
Patients and methods: This research involved 140 HCV-positive patients who were monitored for 12 weeks during their treatment. Of these, 105 patients were treated with a combination of sofosbuvir and daclatasvir (protocol 1), while 35 patients received the same regimen along with ribavirin (protocol 2). Dermatological evaluations were conducted at the start of treatment and weekly during follow-up visits to identify any skin-related side effects.
Results: Dermatological adverse reactions were observed in 48 patients (34%), with 38 patients (36%) in protocol 1 and 10 patients (28%) in protocol 2. The skin-related issues noted during treatment included itching, mild generalized drug eruptions, hyperpigmentation, dry mouth, acne flare-ups, telogen effluvium, and ecchymosis.
Conclusion: Directly acting antiviral therapy might yield some dermatological adverse effects. Most of them are reversible and don’t require stopping of the treatment.