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Cardiometabolic effects of direct-acting antivirals in patients with hepatitis C

Georgios Neokosmidis1, Adonis A Protopapas1, Dimitrios Stogiannou1

  • 1First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.

Gastroenterologia Y Hepatologia
|April 23, 2022
PubMed

Insights

Hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) shows benefits for cardiovascular health and diabetes but has mixed effects on lipids and kidney function. Further research will clarify long-term cardiometabolic outcomes after HCV eradication.

Area of Science:

  • Hepatology
  • Cardiology
  • Endocrinology

Background:

  • Hepatitis C virus (HCV) infection is linked to significant extrahepatic manifestations, notably increased cardiovascular disease (CVD) risk.
  • The advent of direct-acting antivirals (DAAs) offers a curative approach, enabling the study of HCV eradication's impact on associated conditions.

Purpose of the Study:

  • To evaluate the effects of successful HCV treatment with DAAs on various cardiometabolic processes.
  • To synthesize current findings on how HCV eradication influences insulin resistance, diabetes, cardiovascular health, and lipid metabolism.

Main Methods:

  • Review of studies investigating the cardiometabolic effects of DAAs therapy in patients with HCV.
  • Analysis of outcomes related to insulin resistance, type 2 diabetes mellitus, cardiovascular disease, atherosclerosis, lipid metabolism, renal function, and uric acid.

Main Results:

  • DAAs therapy demonstrates positive effects on insulin resistance, type 2 diabetes mellitus, cardiovascular disease, and atherosclerosis.
  • Detrimental impacts on lipid metabolism have been observed, while results for renal function and uric acid metabolism remain inconclusive.
  • Sustained virological response (SVR) is key to observing these cardiometabolic changes.

Conclusions:

  • HCV eradication via DAAs shows promise in reversing certain HCV-associated cardiometabolic complications, particularly cardiovascular risks.
  • Further investigation is needed to fully understand the long-term effects on lipid and renal parameters, and uric acid metabolism.
  • Continued research on patients achieving SVR will provide more definitive conclusions on extrahepatic outcomes.

Keywords:
Antivirales de acción directaCardiovascular riskDirect-acting antiviralsDislipidemiaDyslipidemiaFunción renalHepatitis CInsulin resistanceRenal functionResistencia a la insulinaRiesgo cardiovascular

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