Our sample included 16 males (76.2%) and five females (23.8%) with mean age of 40.90 ± 11.05 years. Two male patients were single (12.5%), one was engaged (6.25%), and 13 were married (81.25%) comparing to one female patient being single (20%), and four being married (80%). Ten male patients lived in the suburbs (62.5%) and six in urban area (37.5%) while all female patients lived in suburbs (Fig. 1). Three males and one female patient had history of smoking with an average of 22.5 pack/year history. None of the patients was alcoholic. One had a haemorrhagic stroke in week 5 and passed away, and the remaining 20 patients continued treatment until the end, and one of them with CTP A had successful renal transplant after SVR24.
All patients who were followed up until SVR24 had 0 copies of HCV RNA when using PCR when treatment started. No patient declared medication ceasing due to adverse effect or deteriorating of the symptoms. No major changes were found in liver and renal function during study period and no major complications or deaths were declared except for one patient who had the stroke and passed away in week 5. ALL patients with CTP B had decompensated cirrhosis as two of them had fluid over-load with ascites and one had encephalopathy in the last six months
.
Hcv Genotypes:
Ten patients (47.6%) had HCV genotype 1a, two (9.5%) genotype 1b, eight (38.1%) genotype 4, and one (4.8%) genotype 5. All females had no cirrhosis or chronic hepatitis whereas ten males (58.8%) had no cirrhosis or chronic hepatitis, four (23.5) had chronic hepatitis with CTP A, and three (17.6%) had decompensated cirrhosis with CTP B (Fig. 2). HCV genotype 1b was correlated with having headache (P = 0.047). Having headache was also correlated with female gender (P = 0.026). However, having a headache overall was only in one patient. No statistical significant difference was found when comparing HCV genotype with any of other symptoms, or smoking (P < 0.05). HCV genotypes were also not associated with gender, being from suburbs, marital status, and CTP scores (P < 0.05).
Ctp Score And Symptoms:
At the end of follow up, regardless it was full or partial, newly-developed symptoms were recorded for 17 patients containing two patients with CTP B, four with CTP A as not all data about symptoms and blood tests could be retrieved. The other 3 patients follow up for symptoms was not valid and the final patient passed away from a stroke at week 5.
Four (23.5%) patients developed lethargy or increased in tiredness, one patient (5.9%) developed sustained headache, seven (41.2%) declared an increase of nausea, five (29.4%) declared an increased frequency of passing stools, four (23.5%) an increased dizziness, one (5.9%) an increased shortness of breath, five (29.4%) an increased insomnia, eight (47.1%) an increased arthralgia, and six (35.3%) an increased mood swinging or more negative mood (Table 1).
Table 1
Symptoms developed in patients after 12 weeks of treatment.
Characteristic | Negative | | Positive |
HCV 1a (n = 10) Lethargy Headache Nausea Diarrhoea Dizziness Shortness of breath Insomnia Arthralgia Mood disturbances | 6 8 4 6 6 7 5 4 4 | | 2 0 4 2 2 1 3 4 4 |
HCV 1b (n = 2) Lethargy Headache Nausea Diarrhoea Dizziness Shortness of breath Insomnia Arthralgia Mood disturbances | 1 1 1 0 2 2 2 1 2 | | 1 1 1 2 0 0 0 1 0 |
HCV 4 (n = 8) Lethargy Headache Nausea Diarrhoea Dizziness Shortness of breath Insomnia Arthralgia Mood disturbances | 5 6 4 5 4 6 4 3 4 | | 1 0 2 1 2 0 2 3 2 |
HCV 5 (n = 1) Lethargy Headache Nausea Diarrhoea Dizziness Shortness of breath Insomnia Arthralgia Mood disturbances | 1 1 1 1 1 1 1 1 1 | | 0 0 0 0 0 0 0 0 0 |
Developing new symptoms were not statistically significantly associated with gender, smoking, marital status, or being from urban or rural area (P < 0.05). Developing arthralgia was insignificantly correlated with smoking (P = 0.072). However, CTP scores were correlated with developing dizziness (P = 0.020) as CTP A had more dizziness than patients with no cirrhosis or chronic hepatitis and patients with CTP B (2 patients) all had dizziness. Moreover, shortness of breath was associated with CTP B (P = 0.019). Although CTP B was associated with lethargy, nausea, arthralgia, and not having headaches or diarrhoea, results were insignificant (P < 0.05). No patient developed any new pulmonary, or dermatology symptoms or coughing.
Cbc And Symptoms:
Mean haemoglobin level and platelet count for patients who achieved SVR24 were respectively 9.04 g/dl and 201712 × 109 per litter when medications were initiated and 9.95 g/dl and 205750 × 109 per litter after 12 weeks. Moreover, 16 patient had anaemia (Hb < 11 g/dl) when initiating drugs and levels ranged from 6.3 to 12.40 g/dl). No statistical significant different was found when comparing age, haemoglobin level and platelet counts at the beginning or the end, HCV RNA copies when diagnosed, with developing lethargy, nausea, diarrhoea, dizziness, shortness of breath, insomnia, arthralgia, and mood disturbances (P < 0.05). No statistical significant different was found when comparing age, haemoglobin level at the beginning or the end, HCV RNA copies when diagnosed with developing headache (P < 0.05). However, it was found that having lower platelets when diagnosed or when after 12 weeks of treatment were correlated with having headache (P = 0.040 and P = 0.086 respectively).
Other Variables:
Gender, being married, or being from suburbs were not significantly associated with HCV RNA copies, amount smoked, haemoglobin levels, or platelet counts (P < 0.05). Higher CTP scores was associated with living in urban areas but P = 0.059 and when comparing having CTP A or B with not, living in urban areas was correlated with having chronic hepatitis or cirrhosis (P = 0.040). CTP scores were not associated with age, HCV RNA copies, amount smoked, haemoglobin levels, or platelet counts (P < 0.05).