الفهرس 
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Abstract
Abstract
Background: Direct-acting antiviral agents (DAAs) have been the
mainstream treatment of hepatitis C (HCV). Cytomegalovirus (CMV) is a
ubiquitous b-herpes virus family, which has a widespread infection.
Infection with CMV is self-limited without eradication. Instead, the virus
remains in a latent state, but reactivation may occur during times where the
immune system is suppressed.
Aim of the work: The study was conducted to evaluate the indirect effect of
DAAs treatment in patients with chronic HCV and past exposure to CMV
infection.
Patients and methods: A prospective cohort study was performed on one
hundred and ninety two Egyptian patients with chronic HCV infection who
were treated with DAAs. They were tested for CMV confection before
treatment and followed up and tested for sustained virological response
(SVR12). Patients with latent CMV were tested for reactivation by testing
for CMV IgM at end of treatment (EOT) (W12).
Results: The study included seventy patients with latent CMV-coinfection
(W0). CMV was reactivated in twenty patients (20/70: 28.5%) at EOT
(positive CMV IgM); CMV DNA viremia by PCR was detected in thirteen
patients (13/20: 65%). They were asymptomatic with significant increase in
S. Bilirubin and FIB-4 &APRI scores at EOT, which decreased at W24 in
comparison to baseline. All of them achieved SVR. Overall SVR was
97.4% among total studied patients (N 192).Conclusion: Reactivation of
CMV may occur with clearance of HCV with DAAs. Presence of CMV
coinfection before treatment doesn’t affect response of treatment of HCV to
DAAs.
Key words: Hepatitis C virus, Direct acting antiviral agents,
Cytomegalovirus and Reactivation.