Hepatitis C: What Treatments Lower Cardiovascular Disease Risk?

Treating hepatitis C virus (HCV) is associated with a significant reduction in the risk of cardiovascular disease (CVD) events, according to the results of a recent study.

Specifically, treatment with direct-acting antiviral (DAA) agents and achieving sustained virologic response (SVR) were associated with the lowest CVD risk.

Infection with HCV has been shown to be associated with an increased risk of cardiovascular disease events, but whether treatment with DAA agents affects this risk is currently unclear.

The researchers conducted a study involving 242,680 HCV-infected veterans, 4436 of whom were treated with a pegylated interferon and ribavirin regimen and 12,667 of whom were treated with a DAA-containing regimen. The participants were matched by age, race, sex, and baseline values with controls who had never been treated for HCV.

Overall, there were 1239 and 2361 incident CVD events in the treated and control groups, respectively. The incidence rate was 30.9 per 1000 patient-years in the control group and 20.3 per 1000 patient-years in the treated group.

Treatment with pegylated interferon and ribavirin (hazard ratio [HR] 0.78) or a DAA regimen (HR 0.57) was associated with a significantly lower risk of a CVD event compared with no treatment, with incidence rates for CVD events of 23.5 per 1000 patient-years in pegylated interferon group, 16.3 per 1000 patient-years in the DAA group, and 30.4 per 1000 patient-years in the control group. Achieving SVR was also associated with a lower risk of incident CVD events (HR 0.87).

“In an analysis of a cohort of HCV-infected Veterans, we found treatment of HCV infection to be associated with a significant reduction in risk of CVD events. Patients treated with a DAA regimen and patients who achieved SVRs had the lowest risk for CVD events.”

—Michael Potts

Reference:

Direct-acting antiviral therapy for HCV infection is associated with a reduced risk of cardiovascular disease events [published online November 13, 2018]. Gastroenterology. DOI: https://doi.org/10.1053/j.gastro.2018.11.022