Effects of Eradication of HCV on Cardiovascular Risk and Preclinical Atherosclerosis in HIV/HCV-Coinfected Patients.

Autor:	Carrero A; Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Berenguer J; Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Hontañón V; Consulta de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, Spain.; Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain., Navarro J; Servicio de Enfermedades Infecciosas, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.; Institut de Recerca Vall d'Hebron, Barcelona, Spain., Hernández-Quero J; Servicio de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain., Galindo MJ; Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario de Valencia, Valencia, Spain., Quereda C; Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain., Santos I; Unidad de Enfermedades Infecciosas, Hospital Universitario de La Princesa, Madrid, Spain., Téllez MJ; Unidad de Enfermedades Infecciosas, Hospital Clínico de San Carlos, Madrid, Spain., Ortega E; Servicio de Enfermedades Infecciosas, Hospital General Universitario de Valencia, Valencia, Spain., Sanz J; Unidad de Enfermedades Infecciosas, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain., Medrano LM; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid., Pérez-Latorre L; Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Bellón JM; Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Resino S; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid., Bermejo J; Unidad de Enfermedades Infecciosas/VIH, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Universidad Complutense, Madrid, Spain; and.; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Barcelona, Spain., González-García J; Consulta de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, Spain.; Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2020 Mar 01; Vol. 83 (3), pp. 292-300.
DOI:	10.1097/QAI.0000000000002260
Abstrakt:	Background: To assess the effects of eradication of hepatitis C virus (HCV) on cardiovascular risk (CVR) and preclinical atherosclerosis in HIV/HCV-coinfected patients. Setting: Prospective cohort study. Methods: We assessed serum lipids, 10-year Framingham CVR scores, pulse wave velocity, carotid intima-media thickness, and biomarkers of inflammation and endothelial dysfunction (BMKs) at baseline and 96 weeks (wk) after initiation of anti-HCV therapy (Rx) in HIV/HCV-coinfected patients. Results: A total of 237 patients were included. Anti-HCV therapy comprised pegylated interferon and ribavirin plus 1 direct-acting antiviral in 55.2%, pegylated interferon and ribavirin in 33.8%, and all-oral direct-acting antiviral in 11.0%. A total of 147 (62.0%) patients achieved sustained viral response (SVR). Median increases in low-density lipoprotein cholesterol in patients with and without SVR were 14 mg/dL and 0 mg/dL (P = 0.024), respectively. Increases in CVR categories were found in 26.9% of patients with SVR (P = 0.005 vs. baseline) and 8.1% of patients without SVR (P = 0.433). This resulted in a significant interaction between SVR and CVR over time (P < 0.001). No significant effect of SVR was observed for pulse wave velocity (P = 0.446), carotid intima-media thickness (P = 0.320), and BMKs of inflammation and endothelial dysfunction. Conclusions: In coinfected patients, eradication of HCV had no effect on markers of preclinical atherosclerosis and BMKs of inflammation and endothelial dysfunction but was associated with a clinically relevant rise in serum low-density lipoprotein cholesterol. Evaluation of CVR should be an integral part of care after the cure of chronic hepatitis C in patients with HIV.
Databáze:	MEDLINE
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