Cardiovascular Risk in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals

Area of Science:

• Hepatology
• Cardiology
• Virology

Background:

• Chronic hepatitis C (CHC) is linked to cardiovascular disease (CVD).
• The impact of achieving sustained virological response (SVR) and liver fibrosis on CVD risk requires further investigation.
• Direct-acting antiviral (DAA) therapies have transformed CHC treatment, necessitating an understanding of their long-term effects on cardiovascular health.

Purpose of the Study:

• To evaluate the changes in Fibrosis-4 (FIB-4) and Atherosclerotic Cardiovascular Disease 2013 (ASCVD) scores up to three years post-DAA treatment.
• To explore the relationship between FIB-4 and ASCVD scores over time after CHC treatment.
• To assess the clinical implications of fibrosis score dynamics on cardiovascular risk.

Main Methods:

• A cohort of 91 CHC patients treated with DAAs was followed for three years.
• FIB-4 and ASCVD scores were measured at baseline, end of treatment, and at 12, 24, and 36 months post-treatment.
• Statistical analyses examined score changes and their associations over time.

Main Results:

• All patients achieved SVR. ASCVD scores showed no significant change from baseline.
• FIB-4 scores significantly decreased post-treatment (average reduction of 0.8, p < 0.001).
• Elevated FIB-4 scores at one and three years post-treatment were associated with higher ASCVD scores (β = 1.16 and 2.52, respectively, p < 0.001). Two patients with non-decreasing FIB-4 scores experienced acute coronary syndrome.

Conclusions:

• FIB-4 and ASCVD scores demonstrated a positive correlation irrespective of the time point after DAA treatment.
• While DAAs improve liver fibrosis markers (FIB-4), their direct impact on ASCVD risk requires further study.
• The utility of FIB-4 scores in cardiovascular risk assessment warrants larger-scale investigations.