Interferon-based therapy reduces risk of stroke in chronic hepatitis C patients: a population-based cohort study in Taiwan.

Background Hepatitis C virus ( HCV) infection has been linked to an increased risk of insulin resistance and carotid atherosclerosis. Aim To investigate the association between HCV infection and stroke, and the effect of interferon-based therapy ( IBT) on stroke risk in chronic hepatitis C ( CHC) patients. Methods We conducted a retrospective cohort study that followed up 3113 subjects with a newly detected HCV infection and 12 452 age- and gender-matched subjects without HCV infection selected from a random sample of 106 beneficiaries from the Taiwan National Health Insurance Program up to 5 years. Use of IBT was defined as treatment with interferon alpha, pegylated interferon alpha-2a or pegylated interferon alpha-2b for at least 3 months. The hazard ratio ( HR) for newly detected stroke was calculated for subjects with HCV compared to those without HCV, and for IBT-treated HCV patients compared to non- IBT-treated HCV patients while adjusting for possible confounding factors. Results The overall person-years of follow-up were 8624.11 in patients with HCV, 54 533.69 in patients without HCV, 666.65 in IBT-treated patients, and 7886.49 in nontreated patients. The multivariable-adjusted hazard ratio ( HR) for newly detected stroke was 1.23 for subjects with HCV compared to the age- and sex-matched subjects without HCV (adjusted HR = 1.23, 95% CI = 1.06-1.42, P = 0.008). Moreover, use of IBT significantly reduced the risk of stroke in HCV patients (adjusted HR = 0.39, 95% CI = 0.16-0.95, P = 0.039) after adjusting for known prognostic factors. Conclusions Interferon-based therapy may reduce the long-term risk of stroke in patients with chronic HCV infection. [ABSTRACT FROM AUTHOR]