Ana Carrero1,2, Juan Berenguer1,2, Víctor Hontañón3,4, Jordi Navarro5,6, José Hernández-Quero7, María J Galindo8, Carmen Quereda9, Ignacio Santos10, María J Téllez11, Enrique Ortega12, José Sanz13, Luz M Medrano14, Leire Pérez-Latorre1,2, José M Bellón1,2, Salvador Resino14, Javier Bermejo1,2,15,16, Juan González-García3,4. 1. Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 2. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain. 3. Consulta de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, Spain. 4. Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain. 5. Servicio de Enfermedades Infecciosas, Hospital Universitari Vall d'Hebrón, Barcelona, Spain. 6. Institut de Recerca Vall d'Hebron, Barcelona, Spain. 7. Servicio de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain. 8. Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario de Valencia, Valencia, Spain. 9. Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain. 10. Unidad de Enfermedades Infecciosas, Hospital Universitario de La Princesa, Madrid, Spain. 11. Unidad de Enfermedades Infecciosas, Hospital Clínico de San Carlos, Madrid, Spain. 12. Servicio de Enfermedades Infecciosas, Hospital General Universitario de Valencia, Valencia, Spain. 13. Unidad de Enfermedades Infecciosas, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. 14. Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. 15. Universidad Complutense, Madrid, Spain; and. 16. Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Barcelona, Spain.
Abstract
BACKGROUND: To assess the effects of eradication of hepatitis C virus (HCV) on cardiovascular risk (CVR) and preclinical atherosclerosis in HIV/HCV-coinfected patients. SETTING: Prospective cohort study. METHODS: We assessed serum lipids, 10-year Framingham CVR scores, pulse wave velocity, carotid intima-media thickness, and biomarkers of inflammation and endothelial dysfunction (BMKs) at baseline and 96 weeks (wk) after initiation of anti-HCV therapy (Rx) in HIV/HCV-coinfected patients. RESULTS: A total of 237 patients were included. Anti-HCV therapy comprised pegylated interferon and ribavirin plus 1 direct-acting antiviral in 55.2%, pegylated interferon and ribavirin in 33.8%, and all-oral direct-acting antiviral in 11.0%. A total of 147 (62.0%) patients achieved sustained viral response (SVR). Median increases in low-density lipoprotein cholesterol in patients with and without SVR were 14 mg/dL and 0 mg/dL (P = 0.024), respectively. Increases in CVR categories were found in 26.9% of patients with SVR (P = 0.005 vs. baseline) and 8.1% of patients without SVR (P = 0.433). This resulted in a significant interaction between SVR and CVR over time (P < 0.001). No significant effect of SVR was observed for pulse wave velocity (P = 0.446), carotid intima-media thickness (P = 0.320), and BMKs of inflammation and endothelial dysfunction. CONCLUSIONS: In coinfected patients, eradication of HCV had no effect on markers of preclinical atherosclerosis and BMKs of inflammation and endothelial dysfunction but was associated with a clinically relevant rise in serum low-density lipoprotein cholesterol. Evaluation of CVR should be an integral part of care after the cure of chronic hepatitis C in patients with HIV.
BACKGROUND: To assess the effects of eradication of hepatitis C virus (HCV) on cardiovascular risk (CVR) and preclinical atherosclerosis in HIV/HCV-coinfectedpatients. SETTING: Prospective cohort study. METHODS: We assessed serum lipids, 10-year Framingham CVR scores, pulse wave velocity, carotid intima-media thickness, and biomarkers of inflammation and endothelial dysfunction (BMKs) at baseline and 96 weeks (wk) after initiation of anti-HCV therapy (Rx) in HIV/HCV-coinfectedpatients. RESULTS: A total of 237 patients were included. Anti-HCV therapy comprised pegylated interferon and ribavirin plus 1 direct-acting antiviral in 55.2%, pegylated interferon and ribavirin in 33.8%, and all-oral direct-acting antiviral in 11.0%. A total of 147 (62.0%) patients achieved sustained viral response (SVR). Median increases in low-density lipoprotein cholesterol in patients with and without SVR were 14 mg/dL and 0 mg/dL (P = 0.024), respectively. Increases in CVR categories were found in 26.9% of patients with SVR (P = 0.005 vs. baseline) and 8.1% of patients without SVR (P = 0.433). This resulted in a significant interaction between SVR and CVR over time (P < 0.001). No significant effect of SVR was observed for pulse wave velocity (P = 0.446), carotid intima-media thickness (P = 0.320), and BMKs of inflammation and endothelial dysfunction. CONCLUSIONS: In coinfectedpatients, eradication of HCV had no effect on markers of preclinical atherosclerosis and BMKs of inflammation and endothelial dysfunction but was associated with a clinically relevant rise in serum low-density lipoprotein cholesterol. Evaluation of CVR should be an integral part of care after the cure of chronic hepatitis C in patients with HIV.
Authors: Mohammad Said Ramadan; Filomena Boccia; Simona Maria Moretto; Fabrizio De Gregorio; Massimo Gagliardi; Domenico Iossa; Emanuele Durante-Mangoni; Rosa Zampino Journal: J Clin Med Date: 2022-09-29 Impact factor: 4.964