People with hepatitis C who receive antiviral therapy have a lower risk of cardiovascular disease compared with those who do not receive treatment, according to study findings published in IJC Heart & Vasculature.

Chronic hepatitis C virus (HCV) infection is known to be associated with cardiovascular disease, and it appears to increase the risk for coronary artery disease, heart attacks and strokes. Some studies suggest that antiviral treatment improves cardiovascular outcomes in people with HCV, but other research has yielded conflicting results.

Dhrubajyoti Bandyopadhyay, MBBS, MD, of New York Medical College at Westchester Medical Center, and colleagues conducted a meta-analysis to better understand the impact of antiviral therapy for HCV on cardiovascular outcomes.

Using the PubMed, Embase and Scopus databases, they identified relevant studies through March 2023. The main outcome was the occurrence of cardiovascular disease overall, with secondary outcomes of all-cause mortality, stroke, peripheral artery disease and myocardial infarction (heart attack).

The study population included 394,452 people with hepatitis C, of whom 111,076 were treated with antiviral therapy and 283,376 did not receive antivirals. The average age in both groups was similar, around 58 years.

Analyzing the pooled population, the study authors found that antiviral therapy was linked to a lower risk of any type of cardiovascular disease compared with not receiving antivirals. In particular, the risk of peripheral artery disease and myocardial infarction was lower in the antiviral group, though the risk of stroke and heart failure was similar in both groups. What’s more, people treated with antivirals had lower all-cause mortality.

There may be multiple reasons why HCV contributes to cardiovascular disease, including endothelial dysfunction, metabolic problems, oxidative stress, vascular injury and inflammation, the researchers noted. In addition to improving cardiovascular health, antiviral treatment also has favorable results for other complications of hepatitis C, including kidney disease, retinopathy, and non-Hodgkin lymphoma=.

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