Besides liver cirrhosis and cancer, people infected with hepatitis C virus (HCV) have increased risk of several other complications, including non-Hodgkin lymphoma and diabetes mellitus.
In the first comprehensive assessment of the effect of antiviral therapy (ATV) for HCV on the risk of extrahepatic manifestations in the U.S., Parag Mahale, PhD, MPH, from the National Cancer Institute, Maryland, and colleagues found that successfully treating HCV may reduce the risk of some conditions, including non-Hodgkin lymphoma.
The retrospective cohort study, published in Gut, an official journal of the British Society of Gastroenterology, looked at data of 160,875 military veterans with HCV from the U.S. Veterans Affairs HCV Clinical Case Registry who had a positive HCV RNA test, which is a test used for early detection of HIV. Most of the patients were men (97.1%), between ages 50 years and 59 years (52.1%), and had genotype 1 (54.7%). Approximately 19% of the patients received ATV, 34% of whom achieved sustained virologic response.
"We compared the risk of medical conditions that have been reported to be associated with HCV infection between three groups: individuals who did not receive any antiviral treatment, those who received treatment without clearing the infection, and those who were successfully treated for HCV,” says Mahale.
The researchers found that compared to HCV-infected individuals who did not receive HCV treatment, those who got treatment and cleared the virus had a reduced risk of some of these conditions. “For example, decreased risk was observed for non-Hodgkin lymphoma, diabetes, and stroke, but not for coronary heart disease,” says Mahale.
Clinicians involved in the care of HCV-infected individuals need to be aware about these additional manifestations of HCV infection, and that early introduction of antiviral treatment may reduce the risk, says Mahale. “These findings are even more relevant in the era of new direct-acting antiviral drugs which can achieve more than 90% cure rate for HCV infection. HCV-infected individuals may develop a number of medical complications due to the infection, the risks for which may be reduced if the infection is treated early and successfully,” he says.