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Impact of DAA Treatment on Cardiovascular Disease Risk in Chronic HCV Infection: An Update

Hrvoje Roguljic1,2,3, Vjera Nincevic1,3, Kristina Bojanic1,3,4

  • 1Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia.

Frontiers in Pharmacology
|May 28, 2021
PubMed

Insights

Hepatitis C virus (HCV) infection increases cardiovascular disease (CVD) risk. Direct-acting antiviral (DAA) treatment significantly reduces CVD events by improving endothelial function and glucose metabolism, despite lipid profile changes.

Area of Science:

  • Hepatology
  • Cardiology
  • Virology

Background:

  • Hepatitis C virus (HCV) infection is linked to increased cardiovascular disease (CVD) events.
  • Atherosclerosis, a key mechanism of CVD, may be promoted by chronic HCV infection via systemic inflammation and direct viral effects within plaques.
  • HCV infection is associated with higher rates of coronary artery disease, heart failure, stroke, and peripheral artery disease.

Purpose of the Study:

  • To evaluate the impact of direct-acting antiviral (DAA) treatment on cardiovascular outcomes in patients with chronic HCV infection.
  • To explore the mechanisms by which HCV eradication influences CVD risk factors.

Main Methods:

  • The study reviews emerging research on HCV infection and its association with cardiovascular events.
  • Analysis of data on DAA treatment efficacy and its effects on extrahepatic manifestations of HCV.
  • Examination of changes in CVD risk factors, including lipid profile, endothelial function, and glucose metabolism, following DAA therapy.

Main Results:

  • DAA-based therapy for HCV infection has shown a 43% reduction in the incidence risk of CVD events.
  • HCV eradication with DAAs positively impacts cardiovascular risk factors, notably improving endothelial function and glucose metabolism.
  • Despite a general worsening of lipid profiles, DAA treatment demonstrates a beneficial effect on overall cardiovascular health.

Conclusions:

  • Direct-acting antiviral treatment is a safe and effective strategy for managing HCV infection, with significant benefits for cardiovascular health.
  • Eradication of HCV with DAAs reduces the risk of major adverse cardiovascular events and improves key metabolic parameters.
  • Further research is warranted to fully elucidate the mechanisms underlying the cardiovascular benefits of DAA therapy.

Keywords:
cardiovascular diseasediabetes mellitusdirect antiviral agentsdyslipidemiahepatitis C virus

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