Hematologic Profile, Vit. B12 and Folic Acid in Cirrhotics Received Sofosbuvir and Daclatasvir With or Without Ribavirin
Hematologic Profile, Vit. B12 and Folic Acid in Cirrhotics Received Sofosbuvir and Daclatasvir With or Without Ribavirin
Use of Ribavirin could affect hematologic profile of the patients negatively. With advent of
 new antiviral therapy, the preexisting hematologic changes may alter or corrected after
 treatment. However, this point is still not properly studied.
Hepatitis C virus (HCV) infection is a global health problem that affects 170 million people
 worldwide, and approximately 55% (95 million) of the infected population is in South East
 Asia and Western Pacific countries.

 Hepatitis C virus (HCV) is considered one of the main causes of chronic hepatitis and also
 may be complicated by serious complications as liver cirrhosis, ascites and hepatocellular
 carcinoma. It is also, one of the leading indications for liver transplantation (LT) in
 adults around the world.

 Abnormalities in hematological parameters are common in patients with cirrhosis. The
 pathogenesis of abnormal hematological indices (HIs) in cirrhosis is multifactorial and
 includes portal hypertension-induced sequestration, alterations in bone marrow stimulating
 factors, viral- and toxin-induced bone marrow suppression and consumption or loss.
 Abnormalities in HIs are associated with an increased risk of complications including
 bleeding and infection.

 So, early recognition and early treatment of those patients with chronic HCV infection can
 modify its natural history. There are many factors affecting the outcome of HCV infection as
 viral, environmental and host factors, including immunologic and genetic susceptibilities.

 Till 2011, the main lines of therapy were Interferon plus ribavirin for at least 48 weeks but
 these combinations was associated with low incidence of Sustained Virological Response (SVR).
 Now, there is era of Direct Acting Analogues that used for treatment of patients with chronic
 HCV infection and associated with high rate of SVR.

 Daclatasvir is a first-in-class HCV NS5A replication complex inhibitor, and Sofosbuvir is a
 nucleotide analogue HCV NS5B polymerase inhibitor. Both have potent antiviral activity and
 broad genotypic coverage and are administered orally once daily.
Inclusion Criteria:

 -  Patients known to have HCV-related liver cirrhosis and candidate for therapy with
 Sofosbuvir and Daclatasvir with or without Ribavirin

 Exclusion Criteria:

 -  Chronic hepatitis due causes other than chronic HCV infection

 -  Coinfection with HIV or HBV infection

 -  Hepatocellular carcinoma

 -  Decompensated cirrhosis