Treatment of hepatitis c with direct acting antiviral drugs can protect against severe acute respiratory syndrome coronavirus 2 infection

Introduction: Owing to the similarity between SARS-CoV-2 and hepatitis C virus (both SARS-CoV-2 Mpro protease and HCV NS3/4A protease are double B-barrel folded with similar orientation), and based on molecular docking models, many researchers suggested using hepatitis C direct acting antiviral drugs (DAAs) for the treatment of SARS-CoV-2 infection. Aims & Methods: This study aimed to estimate the prevalence of SARSCoV- 2 infection among chronic hepatitis C patients receiving treatment with sofosbuvir plus daclatasvir in comparison to chronic hepatitis C patients who finished treatment course one year before COVID-19 pandemic (control group). A retrospective case-control study was designed including 500 chronic hepatitis C patients receiving treatment with sofosbuvir plus daclatasvir (study group) during COVID-19 pandemic (March to September 2020) in comparison to matched 500 individuals who finished treatment course for hepatitis C one year (March to September 2019) before COVID-19 pan demic (control group). Both groups were followed up for 6 months starting from March 2020 up to September 2020. Baseline demographic data, comorbidities, history of confirmed diagnosis of with SARS-CoV-2 infection, residence in an area endemic with SARS-CoV-2 infection or close contact with confirmed or suspected cases were compared in both groups. Results: Our study included 1000 participants (500 in each group), mean age (± standard deviation) was 48.45 (± 7.68) in the study group and 47.67 (± 10.56) in the control group (p value=0.18). Most of participants in the study were males, 400 (80%) in the study group and 380 (76%) in the control group. No significant differences were present in baseline characteristics including area of residence (rural versus urban), level of education, work in medical field, smoking, presence of liver cirrhosis or other comorbidities (Diabetes mellitus, Hypertension, Chest diseases, Cardiac disease, Autoimmune disease or Obesity). In the study group 22 (4.4%) patients had contact with SARS-CoV-2 infected patient while in the control group 24 (4.8%) individuals had contact with SARS-CoV-2 infected patient (p value= 0.88). Patient receiving chronic hepatitis C treatment with sofosbuvir plus daclatasvir had a lower rate of SARS-CoV-2 infection (2.2%, 11 SARSCoV- 2 infections) than individuals in the control group (6%, 30 SARS-CoV-2 infections). Conclusion: Chronic hepatitis C treatment (sofosbuvir plus daclatasvir) can protect against SARS-CoV-2 infection. Larger randomized controlled studies are urgently required to explore the efficacy of sofosbuvir plus daclatasvir combination as a potential therapy for SARS-CoV-2 infection.