# Cardiac effects of direct anti-viral treatment in type II diabetic patients with hepatitis C infection

## TL;DR

This study examines how anti-viral drugs affect heart function in diabetic patients with hepatitis C.

## Contribution

The study reveals early left ventricular systolic dysfunction linked to Sofosbuvir and Daclatasvir in diabetic hepatitis C patients.

## Key findings

- Global longitudinal strain significantly decreased 3 months after treatment with Sofosbuvir and Daclatasvir.
- Left ventricular systolic dysfunction was more pronounced in patients with Child-Pugh class B.
- Other echocardiographic parameters showed no significant changes.

## Abstract

The link between diabetes mellitus and chronic hepatitis C infection remains well established. It is estimated that up to one third of chronic hepatitis C patients have type II diabetes mellitus. Hepatitis C virus infection is one of the main global health burdens. Sofosbuvir and Daclatasvir are used as effective antiviral inhibitors of hepatitis C virus. The cardiovascular effects of those drugs are not well studied. We used electrocardiography and echocardiography with global longitudinal strain assessment by speckle tracking to detect their effect on cardiac function.

One hundred diabetic patients with hepatitis C infection were included in the study. Abdominal ultrasound and laboratory work up were carried out for all participants. Left ventricular systolic and diastolic function were assessed by 2D-echocardiography and global longitudinal strain, before and 3 months after treatment. Results showed significant decrease in global longitudinal strain 3 months after therapy (-21 ± 4 vs. -18 ± 7; P < 0.001) but other echocardiographic findings showed no significant changes.

Sofosbuvir and Daclatasvir were associated with early left ventricular systolic dysfunction as assessed by global longitudinal strain in diabetic patients. More deterioration in left ventricular systolic function was detected among those with Child-Pough class B. Further long-term follow-up may be required.