1. Improvement of carotid atherosclerosis and peripheral artery disease after hepatitis C virus eradication by direct-acting antivirals.
- Author
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Cuciureanu T, Stanciu C, Năstasă RR, Stratina LE, Minea HO, Zenovia IS, Sfarti C, Muzica CM, Huiban L, Stafie RT, Singeap AM, Chiriac Ş, Cojocariu EC, Gîrleanu I, Petrea OC, Timofeiov S, Cuciureanu ID, Rotaru A, and Trifan A
- Subjects
- Humans, Hepacivirus, Antiviral Agents pharmacology, Antiviral Agents therapeutic use, Carotid Intima-Media Thickness, Prospective Studies, Liver Cirrhosis complications, Liver Cirrhosis drug therapy, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy, Peripheral Arterial Disease complications, Peripheral Arterial Disease drug therapy, Hepatitis C, Carotid Artery Diseases complications, Carotid Artery Diseases drug therapy
- Abstract
Introduction: Recent research points to a link between chronic hepatitis C virus (HCV) infection and cardiovascular disease, especially carotid atherosclerosis, and suggests that HCV clearance may impact cardiovascular outcomes., Aim: To determine if viral eradication by the new oral direct-acting antiviral (DAA) agents has benefit regarding carotid atherosclerosis, peripheral artery disease (PAD), steatosis, and liver fibrosis., Patients, Materials and Methods: We conducted a prospective study on 168 patients diagnosed with chronic HCV infection or HCV-related cirrhosis. They were all treated with DAAs, with sustained virological response (SVR). Laboratory data, vibration-controlled transient elastography (VCTE), carotid intima-media thickness (IMT) measurement, and ankle-brachial index (ABI) were recorded in all patients., Results: We found an average IMT of 1.22±0.2 mm, with a variance range from 1.14±0.19 mm in the mild and moderate fibrosis (≤F2) group to 1.29±0.25 mm in the severe fibrosis (≥F3) group. Also, patients with severe fibrosis (≥F3) present a more critical decrease of IMT values, with the carotid thickness affecting only 18.2% of individuals in the follow-up period. At the baseline, the best values of ABI were recorded in patients having F1-F2 fibrosis stage (mean value 1.02±0.19). Instead, in the group with severe fibrosis, the average value of ABI was lower (0.91±0.16) at the baseline, with a significant increase at SVR evaluation (p<0.001)., Conclusions: Our research highlights the beneficial effect of viral eradication on both carotid atherosclerosis and PAD, especially in those with advanced fibrosis and cirrhosis.
- Published
- 2023
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