Background and aim: Chronic hepatitis C virus infection (HCV) is an independent risk factor for atherosclerosis and is associated with the development of cardiac and cerebrovascular events. Among the mechanisms are the production of proinflammatory cytokines, endothelial dysfunction and increased oxidative stress. The effect of sustained virologic response with direct-acting antiviral agents (DAA) on the progression of atherosclerotic disease has had little study.
Objective: Analyze atherosclerotic risk in patients with chronic hepatitis C infection treated with DAA.
Material and methods: Observational, prospective, analytical, comparative study. Adult subjects with a diagnosis of chronic hepatitis C, without coinfections, cardiovascular diseases, type 2 diabetes, or kidney failure and who signed an informed consent letter. We measured body mass index (BMI), blood cell count, lipid profile, liver function tests, glucose, glycated hemoglobin, uric acid, fibrinogen, C-reactive protein (CRP). Carotid doppler ultrasound to measure carotid media-intima thickness (CIMT).
The two proportions formula was used, descriptive statistics and group comparison with t-Student, dichotomous variables with X2 and to show differences the Wilcoxon tests. Project with the approval of the institutional ethics committee.
Results: We analyzed 24 participants 19 (79%) women, the mean age 60±11.4, genotype 1b was the most frequent (41.7%), 9 (37.5%) participants had cirrhosis and 4 of them were Child-Pugh B; mean BMI 28±5.07, 6 participants (25%) were obese and 10 (41.7%) had a smoking history.
The analysis of inflammation markers showed a significant decrease in CRP p<0.05. Pretreatment 19 participants (79.2%) had CIMT<9mm and 5 (20.8%) had CIMT ≥9mm and posttreatment 22 (91.2%) CIMT <9mm and 2 (8.3%) CIMT ≥9mm, that is, there were fewer participants with risk CIMT after treatment (Figures 1 and 2).
Conclusions: Treatment with DAA decreases CIMT and improves inflammation markers such as CRP. However, it is necessary to increase the sample size to define whether there is a decrease in cardiovascular risk.
Conflicts of interest: The authors have no conflicts of interest to declare.
