Changes in tryptophan and phenylalanine in chronic HCV patients treated with direct acting antiviral (sofosbuvir)

Abstract

Background

Chronic hepatitis C virus (HCV) infection represents a global public health challenge, and new drugs have been authorized for its treatment. The current study aimed to detect the change in blood levels of tryptophan and phenylalanine with the recent therapy direct-acting antiviral (sofosbuvir).

Methods

This case-controlled study was conducted on HCV patients including 40 treated with direct-acting antiviral (sofosbuvir), 40 untreated underestimations of full medical history, and laboratory tests involved ELISA assay and real-time (RT) PCR technique as well as measuring tryptophan and phenylalanine by HPLC-UV, in addition to 20 apparently healthy subjects served as a control group.

Results

There is a high statistical significant decrease in tryptophan and increase in phenylalanine in treated cases than untreated cases and control groups. This study showed that phenylalanine at the cutoff of 2.13 μg/ml had 96.9% sensitivity and 62.5% specificity among treated cases; also, tryptophan at the cutoff of 8.53 ng/ml had 81.2% sensitivity and 75% specificity to predict severe depression. There is a statistically significant increase in tryptophan and decrease in phenylalanine in mild/moderate than very severe depression.

Conclusion

Direct-acting antiviral (sofosbuvir) causes a decrease in tryptophan levels and increase in phenylalanine levels that as a result leading to depressive symptoms as adverse effects, so advising by dietary supplements of tryptophan for patients treated from chronic HCV by direct-acting antiviral (sofosbuvir).