Cardioprotective effect of antiviral therapy among hepatitis C infected patients: A meta-analysis

Vikash Jaiswal; Song Peng Ang; Muhammad Hanif; Mayank Jha; Vikash Kumar; Abdelmonem Siddiq; Bhavyakumar Vachhani; Anupam Halder; Michelle Koifman; Herby Jeanty; Siddharath Soni; Madeeha Subhan Waleed; Tushar Kumar; Helen Huang; Dhrubajyoti Bandyopadhyay

doi:10.1016/j.ijcha.2023.101270

Cardioprotective effect of antiviral therapy among hepatitis C infected patients: A meta-analysis

Int J Cardiol Heart Vasc. 2023 Sep 22:49:101270. doi: 10.1016/j.ijcha.2023.101270. eCollection 2023 Dec.

Authors

Vikash Jaiswal^{1

2}, Song Peng Ang³, Muhammad Hanif⁴, Mayank Jha^{1

5}, Vikash Kumar⁶, Abdelmonem Siddiq⁷, Bhavyakumar Vachhani⁶, Anupam Halder⁸, Michelle Koifman⁶, Herby Jeanty⁶, Siddharath Soni⁹, Madeeha Subhan Waleed¹⁰, Tushar Kumar¹¹, Helen Huang¹², Dhrubajyoti Bandyopadhyay¹³

Affiliations

¹ Department of Research, Larkin Community Hospital, USA.
² JCCR Cardiology Research, Varanasi, India.
³ Department of Internal Medicine, Rutgers Health/Community Medical Center, NJ, USA.
⁴ Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
⁵ Department of Medicine and Surgery, Government Medical College, Surat, India.
⁶ Department of Internal Medicine, The Brooklyn Hospital Center, NY, USA.
⁷ Department of Pharmacy, Mansoura University, Mansoura 35516, Egypt.
⁸ Department of Internal Medicine, UPMC Harrisburg, PA, USA.
⁹ Shree Narayan Medical Institute and Hospital, Saharsa, Bihar, India.
¹⁰ Department of Internal Medicine, Lower Bucks Hospital, Bristol, USA.
¹¹ Department of Radiology, Sikkim Manipal Institute of Medical Science, Gangtok, India.
¹² RCSI University of Medicine and Health Sciences, Dublin, Ireland.
¹³ Department of Cardiology, New York Medical College at Westchester Medical Center, NY, USA.

Abstract

Background: Hepatitis C (HCV) infections have been shown to be associated a with higher risk of atherosclerotic cardiovascular disease (CVD). However, the use of antiviral therapy (AVT) and the risk of CVD has not been well established with limited literature.

Objective: We sought to evaluate the association between AVT use post-HCV infection and cardiovascular outcomes.

Methods: We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until 10th March 2023. Primary clinical outcomes were the incidence of any CVD. Secondary endpoints were all-cause of mortality, stroke, myocardial infarction, and peripheral artery disease.

Results: A total of 394,452 patients were included in the analysis (111,076 in the AVT group and 283,376 patients in the NAVT group). The mean age of patients among AVT and NAVT groups was comparable (58.7 vs 58.18). The pooled analysis of primary outcomes showed that AVT was associated with a significantly reduced risk of any CVD (HR, 0.55(95%CI: 0.41-0.75), P < 0.001) compared with the NAVT group of patients. Secondary outcomes including ACM (HR, 0.38(95%CI: 0.32-0.46), P < 0.001), MI (HR, 0.62(95%CI: 0.41-0.94), P = 0.02), and PAD (HR, 0.62(95%CI: 0.41-0.93), P = 0.02) were significantly lower among AVT groups compared with NAVT groups of patients with HCV infection. However, the risk of stroke was comparable between both groups of patients (HR, 0.79(95%CI: 0.58-1.07), P = 0.13).

Conclusion: Our analysis shows HCV-infected patients post-AVT have a significantly lower risk of any CVD, MI, ACM, and PAD compared with NAVT groups of patients.

Keywords: Antiviral therapy; Cardiovascular diseases; Hepatitis C; Outcomes.