Herpes Zoster reactivation in patients with chronic hepatitis C under treatment with directly acting antiviral agents: A case series

Arab J Gastroenterol. 2017 Mar;18(1):39-41. doi: 10.1016/j.ajg.2017.02.003. Epub 2017 Mar 18.

Abstract

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.

Keywords: DAAs; HCV; Herpes Zoster.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects*
  • Coinfection
  • Drug Therapy, Combination
  • Female
  • Hepacivirus*
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / virology
  • Herpes Zoster / complications*
  • Herpes Zoster / drug therapy
  • Herpes Zoster / virology
  • Herpesvirus 3, Human*
  • Humans
  • Male
  • Middle Aged
  • Virus Activation / drug effects*

Substances

  • Antiviral Agents