Herpes Zoster reactivation in patients with chronic hepatitis C under treatment with directly acting antiviral agents: A case series.
We report a series of cutaneous Herpes Zoster (HZ) reactivation cases in patients with hepatitis C virus (HCV) infection treated with directly acting antiviral (DAA) agents. Five cases were detected among 2133 treated patients with DAAs at one of the specialized viral hepatitis treatment centers in Egypt. A control group including 2300 age and sex matched HCV patients who were previously treated with pegylated interferon and ribavirin did not show any HZ reactivation reports while on treatment. None of cases had an evidence of immunosuppression or a risk factor for HZ reactivation. The DAAs used regimens were sofosbuvir/daclatasvir in 4 cases and sofosbuvir/simeprevir in one case. HCV clearance with antiviral therapy may bring immune changes causing reactivation of other latent viral infections like HZ. A high index of clinical suspicion may be needed to guarantee early and prompt management of such cases.
Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt. Electronic address: m_elkassas@yahoo.com.
Mohamed
M
El Kassas
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed Naguib
MN
Wifi
Internal Medicine Department, Assuit University, Assuit, Egypt.
Reem
R
Mahdy
Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Shimaa
S
Afify
New Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt.
Enas
E
Hafez
Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Yasmeen Abd
YA
El Latif
Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Marwa
M
Ezzat
New Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt.
Adel
A
El Tahan
Medical Surgical Department, Faculty of Nursing, Cairo University, Egypt.
Naglaa
N
Youssef
Endemic Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Gamal
G
Esmat
D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D060085:Coinfection; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D014645:Herpesvirus 3, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D014775:Virus Activation / Q000187:drug effects*
D000998:Antiviral Agents
DAAs; HCV; Herpes Zoster