Abstract

Effect of sofosbuvir on QT interval and other electrocardiography (ECG) findings in patients with HCV related decompase cirrhosis

The sofosbuvir is a direct acting antiviral agent commonly used nowadays in patients with decompensated cirrhosis. It has been recently suggested that there is QT interval prolongation in the treatment. Many studies have demonstrated QTc prolongation in patients with cirrhosis. There are no data the effect of sofosbuvir on QT interval and other electrocardiography (ECG) findings in patients with decompase cirrhosis. Our aim in this study was to investigate the effect of sofosbuvir on QT interval and other electrocardiography (ECG) findings in patients with HCV related decompase cirrhosis and relationship between the presence of ECG findings and cardiac events. 

This study is a prospective study. The study included 72 patients with HCV related decompase cirrhosis in treated with ledipasvir/sofosbuvir 24 week (age: 59±11 years; 59% male; Child A/B/C: 0/24/48).  All the patients were performed 12-lead ECG before starting treatment, at the 12 th and 24th week of the treatment (end of the treatment) and 12 week of after the treatment. Demographic, clinical characteristics and hemodynamic parameters of patients were recorded. Heart rate and duration of PR, QRS, QT and corrected QT intervals (QTc) were measured. There were no significant differences in heart rate, PR interval nor QRS interval between patients before and during treatment. QTc was longer in the ECG done during the treatment than the one done before (3.55 ms versus 4.01 ms, p <0.01). Moreover, in 51 patients a third ECG was performed in the twelfth week after treatment. There were no significant differences in heart rate, PR interval, QRS interval, QTc (p >0.05) between measurements before and after treatment. In the subgroup of patients taking sofosbuvir there were neither significant differences in the QTc before and after treatment (p >0.05).

CONCLUSION: In patients on treatment with sofosbuvir a statistically significant prolongation of the QTc interval was in the during treatment but this elongation was not clinically relevant.