Respiratory adverse effects of Sofosbuvir-based regimens for treatment of chronic hepatitis C virus

Abstract Background Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide and new drugs were licensed for its treatment. Quite a few studies worked on spectrum of respiratory side effects associated with those new therapies. This work aimed to evaluate respiratory side effects associated with sofosbuvir-based regimens used for treatment of chronic HCV. Methods This study included 418 patients with HCV infection classified into 3 groups according to the treatment regimen: Group 1 (IFN-Sof-Rib): received triple therapy of sofosbuvir, pegylated interferon (Peg IFN)-α and ribavirin for 12 weeks. Group 2 (Sof-Rib): received combined therapy of sofosbuvir, and ribavirin for 24 weeks, and Group 3 (Sof-Dacl-Rib): received triple therapy of sofosbuvir, daclatasvir and ribavirin for 12 weeks. All patients underwent baseline assessment including history taking, clinical examination, routine laboratory investigations, α-feto-protein, polymerase chain reaction for HCV RNA, abdominal ultrasound, and electrocardiogram. Patients then were followed monthly during the course of treatment for any respiratory side effects. Plain chest X-ray, high resolution computed tomography, spirometry, bronchial challenge test, and/or fiberoptic bronchoscopy and bronchoalveolar lavage were performed as indicated. Results Cough was the commonest symptom in all groups (5.9%, 13%, and 7% in groups 1, 2, and 3 respectively). Obstructive ventilatory defect was the prominent pattern in the three groups without statistically significant difference (p = 0.181). Bronchitis was the most common finding in the three groups (2.2%, 5.8% and 3.5% in group 1, 2, and 3 respectively). It was followed by upper respiratory tract infection (URTI) in group 2 (4.5%). URTI and bronchial hyperresponsiveness (BHR) occurred equally in group 1 (1.5%) and group 3 (1.7%). Conclusion Sofosbuvir-based regimens used for treatment of chronic HCV infection are considered safe with minor respiratory adverse effects. However, larger multicenter studies are required for further assessment.