Evidence map›Paper›PMID 41921306›Full record

ArticleClinics (Sao Paulo, Brazil)2026

Cardiac safety of sofosbuvir-based direct-acting antivirals in hepatitis C patients with pre-existing heart disease.

Amr Shaaban Hanafy, Mohamed Sorour Mohamed, Osama Attia, Ayman Fathy Elsayed Mohammed, Ahmad M Hassaneen, Rania Naguib, Eslam Kamal Fahmy, Hany A Elkattawy

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Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Amr Shaaban HanafyInternal Medicine Department, Gastroenterology and Hepatology Division, Zagazig University, Zagazig, Egypt.
Mohamed Sorour MohamedInternal Medicine Department, Gastroenterology and Hepatology Division, Zagazig University, Zagazig, Egypt.
Osama AttiaInternal Medicine Department, Zagazig University, Zagazig, Egypt.
Ayman Fathy Elsayed MohammedInternal Medicine Department, Gastroenterology and Hepatology Division, Zagazig University, Zagazig, Egypt.
Ahmad M HassaneenClinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Rania NaguibDepartment of Internal Medicine, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
Eslam Kamal FahmyDepartment of Physiology, College of Medicine, Northern Border University (NBU), Arar, Saudi Arabia; Department of Physiology, College of Medicine, Zagazig University, Zagazig, Egypt.
Hany A ElkattawyDepartment of Basic Medical Sciences, College of Medicine, Almaarefa University, Riyadh, Saudi Arabia; Research Center, Deanship of Scientific Research and Post-Graduate Studies, AlMaarefa University, Riyadh, Saudi Arabia. Electronic address: hmohammed@um.edu.sa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDirect-Acting Antivirals (DAAs) are effective in 95% of patients, but concerns about potential cardiotoxicity and decreased Warfarin Sensitivity (WS) need further investigation. The study aimed to evaluate the safety and effectiveness of sofosbuvir-based therapy in patients with significant heart diseases, considering potential drug interactions and their impact on cardiac function.

methodsThe study involved 100 patients with HCV genotype 4, including 40 with ischemic heart disease, 20 with prosthetic valve replacement, 20 with NYHA class I‒II heart failure, and 20 with systemic hypertension. All received sofosbuvir-based antiviral therapy and underwent routine laboratory tests, N-Terminal B-type Natriuretic Peptide (NT-Pro BNP), abdominal ultrasound, and echocardiography at baseline and three months post-treatment.

resultsNinety-six patients achieved SVR, resulting in improved cardiac ejection fraction (EF) from 53.2 ± 8.8% to 56.2 ± 6.9% (p = 0.000) and reduced left atrial volume (LAV) from 43.2 ± 4.2 to 41.7 ± 3.9 mm (p = 0.008). Liver stiffness also improved (p = 0.013), and no disabling symptoms were reported. MAPSE increased from 8.4 ± 2.4 mm to 9.5 ± 2.5 mm, and interventricular septum thickness (IVT) decreased from 12.5 ± 1.8 mm to 10.9 ± 1.3 mm (p = 0.001 and P = 0.000, respectively). The warfarin dose needed to be increased to optimize INR after SVR, but this adjustment did not affect WS (p = 0.16).

conclusionSofosbuvir-based antiviral therapy was well tolerated and demonstrated a reassuring cardiac safety profile in HCV patients with pre-existing heart disease, with no major arrhythmias or adverse cardiac events observed during or after therapy.

Indexed as

Cardiac functionHCVOutcomeSofosbuvir

Identifiers

PMID41921306
PMCPMC13068614

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