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 (Figure 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 had successful renal transplant after SVR12.
All patients who were followed up until SVR12 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.
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 whereas three males (17.6%) had clinical and radiological findings of cirrhosis with CTP B (Figure 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, 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 the two patients with compensated cirrhosis and CTP B 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).
Developing new symptoms were not statistically significantly associated with gender, or smoking, (P<0.05). Developing arthralgia was insignificantly correlated with smoking (P = 0.072). However, CTP scores were correlated with developing dizziness (P = 0.007) as patients with CTP B (2 patients) all had dizziness. Moreover, CTP type B was associated with shortness of breath (P = 0.005), and nausea (P = 0.072) as only one patient had shorness of breath and he had CTP type B. Although CTP B was associated with lethargy, 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 SVR12 were respectively 9.04 g/dl and 201712 x 109 per litter when medications were initiated and 9.95 g/dl and 205750 x 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:
No statistical significance was found when comparing HCV RNA copies, smoking cigarettes, amount smoked, haemoglobin levels, or platelet counts (P<0.05).