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Genetic factors may play a role in fibrosis progression in patients with chronic hepatitis C (CHC). A cirrhosis risk score (CRS7) with seven single nucleotide polymorphisms was previously shown to correlate with cirrhosis in patients with CHC. This study aimed to assess the validity of CRS7 as a marker of fibrosis progression and cirrhosis and as a predictor of clinical outcomes in patients with CHC.

Background:Behavioral counseling has been shown to improve modifiable cardiovascular risk factors. We asked whether the 10-year risk for ASCVD events could be reduced within the first year of a digital (on-line) counseling program.Methods:Individuals were included in the study if they (i) participated in an annual employer-sponsored wellness program with year-end biometric screening for 3 years (2016, 2017, and 2018), (ii) had metabolic syndrome at the end of 2017, and (iii) completed at least 9 lessons in a digital behavioral counseling program initiated at the beginning of 2018. Paired t-Tests and McNemar tests were used to assess changes in ASCVD risk before and after intervention.Results:The baseline characteristics of the 144 participants are shown in the table. Participants engaged in the counseling program for a mean of 8.9 months (SD, 1.3) and completed a mean of 24 lessons (SD, 12). In the year before participation in counseling (2016-2017), mean 10-year ASCVD risk increased from 3.5% to 4.4%, P=0.0002 for difference in the annual ASCVD risk change before and after the program. In the year after participation in the counseling program (2017-2018), mean 10-year ASCVD risk decreased from 4.4% to 3.6%, and the fraction of participants with 10-year ASCVD risk ?5% decreased from 30% to 22%: P=0.04. Metabolic syndrome was substantially reduced (p<0.0001), and CVD risk factors were shifted in a favorable direction (Table).Conclusions:In participants with metabolic syndrome digital behavioral counseling reduced 10-year ASCVD risk after the first year on the program.