Studies reporting on the association between HCV and cardiovascular disease (CVD), and effect of HCV treatment upon future risk of CVD have shown mixed results.
Within ERCHIVES (Electronically Retrieved Cohort of HCV Infected Veterans), we identified all persons treated for >=7 weeks and propensity-score matched group who never received HCV treatment. We excluded those with HIV, HBV or previously diagnosed CVD. Incidence rate (per 1,000 person-years) and risk factors for CVD events (Cox proportional hazards analysis) were determined for various treatment groups. CVD events were identified using ICD-9CM/ICD-10 codes. Kaplan-Meier plots were generated to show and compare CVD-free survival by treatment status and attainment of SVR.
Among 32,575 treated and same number of untreated persons in the final dataset, median age was 58 years, 27% were Black race and 96% were male. The incidence rate for CVD events/1,000 person-years (95% CI) among the treated was 19.10 (17.79, 20.50) vs. 32.37 (30.51, 34.33) among the untreated (P<0.01). Treatment with a DAA regimen (vs. PEG/RBV; HR [95% CI] 0.68 [0.53,0.88]) and achieving SVR (HR [95% CI] 0.76 [0.63,0.92]) were associated with a lower risk of incidence CVD event. (Table) Kaplan-Meier curves demonstrated that untreated persons had a shorter CVD event-free survival during 30 months of follow-up compared with the treated persons. (figure; Logrank p<0.0001)
HCV treatment is associated with a reduction in incident CVD events. Directly acting antiviral regimens (vs. PEG/RBV) and attainment of SVR (vs. no SVR) are associated with a lower risk of incident CVD events.
A. Ajwad Butt,
A. Shuaib, None
A. B. Abou-Samra, None
O. Saikh, None
M. Freiberg, None