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Hepatitis C Virus Clearance by Direct-Acting Antivirals Agents Improves Endothelial Dysfunction and Subclinical

Rocío Muñoz-Hernández1,2, Javier Ampuero1,2,3, Raquel Millán1

  • 1SeLiver Group, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, España.

Clinical and Translational Gastroenterology
|September 21, 2020
PubMed

Insights

Hepatitis C virus (HCV) clearance significantly improves cardiovascular health by reducing endothelial dysfunction and subclinical atherosclerosis. Treatment with direct-acting antivirals enhances vascular function and lowers key inflammatory markers.

Area of Science:

  • Cardiovascular disease
  • Hepatology
  • Vascular biology

Background:

  • Hepatitis C virus (HCV) infection is linked to increased cardiovascular (CV) risk.
  • Direct-acting antiviral agents (DAAs) offer a curative treatment for HCV.
  • The impact of HCV clearance on CV risk factors requires further investigation.

Purpose of the Study:

  • To evaluate the effect of sustained virological response (SVR) after DAA treatment on endothelial dysfunction and subclinical atherosclerosis in HCV patients.
  • To analyze changes in CV risk markers following HCV eradication.

Main Methods:

  • Prospective study of 114 HCV patients treated with DAAs.
  • Assessment of endothelial dysfunction (laser Doppler flowmetry) and subclinical atherosclerosis (ABI) at baseline, 12 weeks (SVR), and 1 year post-treatment.
  • Measurement of lipid profile, oxidative stress markers (OLAbs), adhesion molecules (VCAM, e-selectin), angiogenesis markers, apoptotic microparticles (EMPs, PMPs), and cell-free DNA (cfDNA).

Main Results:

  • HCV clearance improved endothelial function, indicated by increased hyperemia (P=0.013), and reduced levels of VCAM, e-selectin (P<0.001), and cfDNA (P=0.017).
  • Subclinical atherosclerosis improved, with a significant increase in ABI (P<0.001) in patients with baseline atherosclerosis.
  • Levels of endothelial and platelet microparticles (EMPs, PMPs) decreased post-SVR and at follow-up (P=0.006, P=0.002).

Conclusions:

  • Sustained virological response achieved with DAAs improves endothelial dysfunction and subclinical atherosclerosis in HCV patients.
  • HCV clearance positively impacts vascular health by reducing inflammatory and pro-apoptotic markers.
  • This study highlights the cardiovascular benefits of HCV eradication therapy.
Abstract

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