Curing hepatitis C reduces the risk of cardiovascular events in people with compensated cirrhosis, a large French study presented this week at the International Liver Congress in Amsterdam shows.

Presenting the findings, Patrice Cacoub of Hôpital Pitié-Salpêtrière, Paris, stressed the importance of thinking of hepatitis C as a systemic disease that affects the heart, the kidneys, blood vessels, the brain and glucose metabolism through mechanisms that are still to be fully understood. Hepatitis C is also associated with an increased risk of non-hepatic cancers, especially non-Hodgkin lymphoma.

Hepatitis C infection increases the risk of cardiovascular disease – events such as heart attack, stroke, peripheral artery disease and heart failure – especially older people and those with diabetes or high blood pressure. Hepatitis C may promote heart disease by causing metabolic problems, but may also do so by causing inflammation.

What is less clear is whether hepatitis C treatment and sustained virologic response after treatment affect the risk of cardiovascular diseases.

The study population consisted of people with hepatitis C and cirrhosis without symptomatic liver disease (Child Pugh A stage) who had detectable HCV virus at baseline.

During the follow up period 79 major cardiovascular events occurred in 62 members of the cohort population and 15 people died, seven due to a cardiovascular event. The most common event was heart failure (23 reported cases) followed by stroke (16 people). Heart attack and cardiac arrest were less common.

Having a sustained virologic response to treatment during the follow-up period reduced the risk of a cardiovascular event by 65%.

Multivariate analysis showed that hypertension, smoking and low serum albumin were significant predictors of a cardiovascular event. But the strongest predictor of cardiovascular was ethnicity. People of East Asian origin were nine times more likely to experience a cardiovascular event.

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