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. 2020 Oct 27;12(10):841-849.
doi: 10.4254/wjh.v12.i10.841.

Effect of treating chronic hepatitis C with direct-acting antivirals on extrahepatic cutaneous manifestations

Mohamed El Kassas  1 , Osama Mo Hegazy  2 , Eman M Salah  2
Affiliations

Effect of treating chronic hepatitis C with direct-acting antivirals on extrahepatic cutaneous manifestations

Mohamed El Kassas et al. World J Hepatol. .

Abstract

Background: Hepatitis C virus (HCV) is a disease with a significant global impact, affecting approximately 2%-2.5% of the world's population. New direct-acting antivirals (DAAs) have been introduced over the past few years with great success in viral eradication. The association of chronic HCV infection with a wide spectrum of cutaneous manifestations has been widely reported in the literature.

Aim: To assess the effect of treating HCV with DAAs on the extrahepatic cutaneous manifestations of HCV.

Methods: This prospective observational study included 1039 HCV positive Egyptian patients who were eligible to receive DAAs. A total of 30 patients were diagnosed with extrahepatic cutaneous manifestations and fulfilled the inclusion criteria of the study. Of these patients, 6 had classic lichen planus, 8 were diagnosed with psoriasis vulgaris and 16 had pruritus. All patients received DAAs from October 2018 to July 2019 in the form of a three-month course of sofosbuvir/daclatasvir combination. Patients with lichen planus or psoriasis were dermoscopically evaluated before treatment and 6 mo after treatment, while patients with hepatic pruritus were assessed using the 12-Item Pruritus Severity Scale over the same period.

Results: All patients with psoriasis showed significant improvement in all psoriatic plaques, and all patients with hepatic pruritus scored 0 on the 12-Item Pruritus Severity Scale indicating total improvement of pruritus. In addition, four of six patients with lichen planus showed complete improvement.

Conclusion: Treatment of HCV with DAAs was significantly effective in improving virus-related extrahepatic cutaneous manifestations.

Keywords: Cutaneous manifestations; Directly acting antivirals; Extrahepatic manifestations; Hepatitis C virus; Lichen planus; Pruritus.

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Conflict of interest statement

Conflict-of-interest statement: Author Mohamed El Kassas is an advisory committee board member in AbbVie and shared in speaking & teaching activities for Roche, MSD, AbbVie, Eva, Mash Premier, Takeda, Organon, AUG, Inspire, HSO, received grants and research support from Gilead Sc., Intercept, Rameda, Ipsen, and Alfa Cure. Osama MO Hegazy and Eman Salah declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Shows lichen planus papules on the hand of a patient (A) before and (B) after receiving direct-acting antivirals as treatment for hepatitis C virus infection. Dermoscopic image of the lichen planus papules (C) before and (D) after receiving direct-acting antivirals as treatment for hepatitis C virus infection.
Figure 2
Figure 2
Shows psoriatic plaques on the back of a patient (A) before and (B) after receiving direct-acting antivirals as treatment for hepatitis C virus infection and on thighs (C) before and (D) after receiving treatment. Dermoscopic image of the psoriatic plaques (E) before and (F) after receiving direct-acting antivirals as treatment for hepatitis C virus infection.
See this image and copyright information in PMC

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