Hepatitis C virus (HCV) eradication by direct antiviral agents (DAAs) improves carotid atherosclerosis in patients with advanced fibrosis and compensated cirrhosis, according to a study published in the Journal of Hepatology.
Salvatore Petta, Assistant Professor at the Center for Gastroenterology and Hepatology, University of Palermo, Italy, and colleagues, evaluated 182 consecutive HCV patients with advanced fibrosis or compensated cirrhosis by virologic, anthropometric, and metabolic measurements. All patients underwent DAA-based antiviral therapy according to AISF/EASL guidelines. Intima-media thickness (IMT), carotid thickening (IMT≥1 mm), and carotid plaques were evaluated by ultrasonography at baseline and 9 to 12 months after the end of therapy.
A total of 56% of patients were men, mean age was 63.1 years, and 65.9% had compensated cirrhosis. One patient in 5 had diabetes, 14.3% were obese, 41.8% had arterial hypertension, and 35.2% were smokers. Mean IMT was 0.94 mm, 42.9% had IMT≥1 mm, and 42.9% had carotid plaques.
All patients achieved a 12-week sustained virologic response. IMT significantly decreased from baseline to follow-up (0.94±0.29 mm vs 0.81±0.27). A consistent, significant reduction in the prevalence of patients with carotid thickening from baseline to follow-up was observed (42.8% vs 17%), while no changes were reported for carotid plaques (42.8% vs 47.8%). These results were confirmed in subgroups of patients stratified for cardiovascular risk factors and liver disease severity.
“HCV eradication by DAA improves carotid atherosclerosis in patients with severe fibrosis without or with additional metabolic risk factors,” the authors concluded. “The impact of this improvement in the atherosclerotic burden in terms of reduction of major cardiovascular outcomes is worth investigating in the long term.”
Petta S, Adinolfi LE, Fracanzani AL, et al. Hepatitis C virus eradication by direct antiviral agents improves carotid atherosclerosis in patients with severe liver fibrosis. J Hepatol. 2018 Mar 2. doi: 10.1016/j.jhep.2018.02.015 [Epub ahead of print].