title: Safety of direct antiviral agents in the management of hepatitis C.
abstract: Hepatitis C virus is a hepatotropic virus that generally leads to chronic hepatitis and various harmful sequelae. The lone standard of treatment has been pegylated interferon and ribavirin, which produces a modest response and many side effects. However, a new era of management was declared with the introduction of various directly acting antiviral agents. Areas covered: Recent direct antiviral agents (DAAs) primarily target the non-structural proteins of the virus and affect its replication. These agents successfully achieve a sustained virologic response. However, some serious side effects were reported, which may or may not be drug-related effects. Important drug-drug interactions were also reported. The treating physician should be reasonably familiar with these effects. We review the safety profile of these agents in the management of HCV. Expert opinion: Cautious concomitant drug intake is necessary for the new HCV therapies. Future HCV management will depend on interferon-free and likely ribavirin-free regimens. The co-administration of direct antiviral agents of different classes increases the probability of side effects and drug-drug interactions.
authors.affiliation: a Endemic Medicine Department, Faculty of Medicine , Helwan University , Cairo , Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Kassas
authors.affiliation: b Endemic Hepatogastroenterology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Tamer
authors.initials: T
authors.lastname: Elbaz
authors.affiliation: c Clinical Pharmacy Unit , New Cairo Viral Hepatitis Treatment Unit , Cairo , Egypt.
authors.forename: Enas
authors.initials: E
authors.lastname: Hafez
authors.affiliation: b Endemic Hepatogastroenterology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004347:Drug Interactions; D016174:Hepacivirus / Q000187:drug effects*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents
keywords: Direct antiviral agents; drug interactions; hepatitis C (HCV); safety; side effects