Studying the Kynurenine, Some Hematological and Biochemical Changes on Egyptian Patients with Chronic Hepatitis C During and After Treatment with Sofosbuvir

Document Type : Original Research Papers

Authors

1 Zoology Department, Faculty of Science, Benha University

2 Benha Teaching hospital, General Organization of Teaching Hospitals and Institutes, Ministry of health

Abstract

Background: Hepatitis C virus (HCV) is a serious health problem where its prevalence is very high in Egypt. Development of new therapeutics Sofosbuvir, a recently approved nucleotide analog, is a highly potent inhibitor of the NS5B polymerase in the HCV, and has shown high efficacy in combination with several other drugs with and without pegylated interferon.
Objectives: This work aimed to investigate the effect of the treatment with the antiviral Sofosbuvir on serum Kynurenin, some hematological and biochemical changes in patients with HCV during and after treatment.
Subjects and methods: The study was conducted on 180 individuals classified as follows: 47 healthy normal adult served as control group and 133 chronically infected HCV adult Egyptian patients divided into 2 groups according to the type of treatment, group II patients who received dual combination therapy of Sofosbuvir (SOF) and Ribavirin (RBV) for 24 weeks, and group III patients who received a triple combination therapy of SOF, pegylated interferon (PEG-IFN) Alfa, and RBV for 12 weeks. Fasting blood samples pre-, during and after treatment were collected.
Results: All reported data were compared to control group. The obtained data showed that there were no significant differences between all studied groups regarding gender and age.. The data showed a significant increase (p >0.01 or 0.001) in serum aspartate aminotransferase (AST) & alanine aminotransferase (ALT) activities, total & direct bilirubin and kynurenine (KYN),white blood cells (WBCs) and prothrombin time in Gr .IIA & Gr III A as compared to control group, whereas there were significant decrease (p >0.05)in blood platelets count (PLTs) and serum albumin, urea &creatinine in Gr .IIA & Gr III A. During treatment in Gr. II B & Gr. III B, serum AST, ALT activites, direct bilirubin, and PLT & PT were improved, yet still showing significant increase (p>0.05), while the increase serum KYN was non-significant p >0.05 from control in Gr .II B and Gr. II C. Serum albumin, creatinine& urea and WBCs were returned to their normal levels after treatment(Gr .II C & Gr. III C), while hemoglobin (Hb) & red blood cells (RBCs) showed
significant decrease(p >0.05 ) after treatment (Gr .II C& Gr. III C).The other tested biochemical parameters were returned to their normal levels except total bilrubin that showed significant increase (p >0.05) in Gr .II C& Gr. III C and serum ALT & KYN that showed significant increase (p >0.05) in Gr III C. While, Hb & RBCs and PLT showed (p >0.01) , significant decrease. Both WBCs & HCT showed normal values in Gr. II B & Gr. II C, whereas those in Gr. III C showed significant decrease. No significant changes in fasting blood sugar (FBS) in Gr. II & Gr. III (Pre, during and after treatment).
Conclusion: It can be concluded that the dual therapy of Sofosbuvir for 24 weeks caused improvement of most of the tested parameters of HCV patient .Thus it has little metabolic harm

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