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DAA use decreases risk for cardiovascular events in patients with advanced fibrosis, HCV

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Lam L, et al. Abstract OS006. Presented at: International Liver Congress; June 22-26, 2022; London (hybrid meeting).

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LONDON — Direct-acting antiviral treatment correlated with a decreased risk for cardiovascular outcomes among patients with hepatitis C virus and advanced fibrosis but an increased risk for arrhythmias and conduction disorders.

“Several studies have revealed that hepatitis C virus can induce chronic inflammation and immune dysregulation, and this immune dysregulation and chronic inflammation explained the development of extrahepatic manifestations in chronic hepatitis C patients, including cardiovascular disease,” Laurent Lam, MD, a physician and doctoral researcher at the Pierre Louis Institute of Epidemiology and Public Health at Sorbonne University in Paris, told attendees at the International Liver Congress. “Few data are available regarding the long-term impact of DAAs on the occurrence of non-liver events.”

Using the prospective ANRS CO22 HEPATHER cohort, which derived individual data from the French National Health Insurance Database, Lam and colleagues analyzed 8,148 patients with chronic HCV between August 2012 and December 2015 for cardiovascular events and cancer incidence. The primary outcome was the association between DAA use and extrahepatic events.

Among 22,326 and 12,905 person-years of DAA and no DAA exposure, analysis showed DAA exposure correlated with a reduced risk for peripheral arterial disease (HR = 0.54; 95% CI, 0.33-0.89), an overall beneficial effect on cardiovascular among patients with HCV/advanced fibrosis (adjusted HR = 0.58; 95% CI, 0.42-0.79) and an increased risk for arrhythmias and conduction disorders (HR = 1.46; 95% CI, 1.04-2.04).

Lam and colleagues observed no association between DAA use and extrahepatic cancer (HR = 1.23; 95% CI, 0.5-3.03).

“Direct-acting antiviral exposure reduced the risk for peripheral arterial disease, overall cardiovascular events and increased risk for arrhythmias and conduction disorders,” Lam concluded. “Direct acting antivirals are not associated with extrahepatic cancer development or reduction in our study.”