Abstract: Objective To investigate the alterations in monocyte subsets and phenotypes in treatment-naive chronic hepatitis C patients undergoing daclatasvir and sofosbuvir therapy. Methods A total of 94 treatment-naïve chronic hepatitis C patients were enrolled in this study at our hospital from August 2021 to February 2023, excluding individuals with drug-induced, hereditary, or autoimmune liver diseases. The patients were randomly assigned to either a conventional therapy group or a combination therapy group, with 47 cases in each group. The conventional therapy group received IFNα-2a injections, while the combinaton therapy group was treated with a combination of daclatasvir and sofosbuvir. The levels of TBil, TBA, ALT, AST, GGT, ALP, γ-GT were compared between the two groups, and the expression of CD14⁺CD16⁺/CD14⁺ and CD14⁺CD16^-/CD14⁺ was assessed using flow cytometry. Adverse events were monitoreded and compared between the two groups for further analysis. Results After treatment, the combination therapy group showed significantly lower levels of TBil and TBA compared to the conventional therapy group (P<0.05). Similarly, the levels of ALT and AST were significantly lower in the combination therapy group (P<0.05). Additionally, the levels of GGT, ALP and γ-GT were significantly reduced in the combination therapy group (P<0.05). Furthermore, the combination therapy group exhibited lower expression of CD14⁺CD16⁺/CD14⁺ and higher expression of CD14⁺CD16^-/CD14⁺ compared to the conventional therapy group (P<0.05). Conclusion Combination therapy with daclatasvir and sofosbuvir in treatment-naïve chronic hepatitis C patients may alleviate hepatocyte damage, resulting in improvements in inflammatory and liver function. Additionally, this combination therapy can modulate monocytes, enhancing the immune response in these patients.

Key words: Chronic hepatitis C, Daclatasvir, Sophie Bouvet, Monocyte subsets