Changes in Bone Microarchitecture and Inflammatory Cytokines After Cure of Chronic Hepatitis C Infection With...

It remains unclear if cure of hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs) ameliorates HCV-related inflammation and bone deficits. We evaluated changes in cytokines and bone measurements by high-resolution peripheral quantitative computed tomography (HR-pQCT) prior to DAA treatment and 18 months following initiation and compared changes in uninfected controls over 18 months.

We conducted a cohort study of 40 participants who initiated DAAs and achieved cure and 48 without HCV as controls. At enrollment and 18 months later, participants had measurements of volumetric bone mineral density, cortical dimensions, and mechanical properties of the radius and tibia by HR-pQCT; visceral fat area and appendicular lean mass by whole-body dual-energy X-ray absorptiometry; and serum tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and interleukin 18 (IL-18). Multivariable linear regression was used to estimate group differences in mean changes in bone measurements and cytokines.

We observed no significant differences in month 0-18 changes in HR-pQCT measurements between participants with cured HCV and controls in unadjusted models or after adjustment for age, sex, appendicular lean mass index, visceral fat area, and smoking. Participants with cured HCV had decreases in IL-18 (mean change, -0.085 vs +0.086 log pg/mL; P < .001) and TNF-α (mean change, -0.050 vs +0.084 log pg/mL; P < .001), but not IL-6 (mean change, +0.108 vs +0.009 log pg/mL; P = .214) versus controls.

Participants with cured HCV had no significant changes in bone microarchitecture by HR-pQCT 18 months after DAA initiation compared with controls, but did have decreases in IL-18 and TNF-α versus controls.