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Effect of treating chronic hepatitis C with direct-acting antivirals on extrahepatic cutaneous manifestations
Mohamed El Kassas1, Osama Mo Hegazy2, Eman M Salah2
1Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11795, Egypt. m_elkassas@yahoo.com.
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.
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