Background: many extrahepatic manifestations including autoimmune, rheumatic disease and metabolic bone impairment
have
been stated in hepatitis C virus (HCV) infected patients. Direct
antiviral agents (DAAs) are major developments in the treatment of
HCV infection and were reported to have effect on the
musculoskeletal manifestations. Objectives: to evaluate the effect
of hepatitis C and direct antiviral agents (DAAs) on
musculoskeletal system, bone mineral density (BMD). Methods:
the current study involved 60 patients with hepatitis C, 30 patients with
no history of anti-viral agent’s treatment (group I) and the other 30
patients achieved response on DAAs within the last year (group II).
All patients were subjected to history taking, physical examination,
investigations including (calcium, Phosphorus, Parathormone
hormone, alkaline phosphatase and vitamin D) and DEXA scan for
BMD measurement. Results: In this study, group I showed
significantly lower bone mineral density compared to group II .
The frequency of musculoskeletal manifestations caused by HCV
in group I is higher than group II including: arthralgia (70%), sicca symptoms (50%), fatigue
(40%), fibromyalgia (20%), arthritis and cryoglobinemic vasculitis (10%). Conclusion:
Musculoskeletal manifestations including decreased BMD are frequent in chronic hepatitis C
(CHC) patients and treatment with DAAs proved a beneficial impact.