Effect of Hepatitis C Treatment on Risk of Developing Cardiovascular Disease and Cardiac Arrhythmias

Abstract

Background: Chronic hepatitis C virus (HCV) infection affects more than 70 million people worldwide, is a systemic disease and has been implicated as a risk factor for cardiovascular disease (CVD). Objective: We sought to study the association between risk of CVD between 0-12 month and 12-24 months of HCV treatment initiation. Methods: 567,956 Hepatitis C patients without prior history of CVD were identified in the Cerner Health Facts database. Of these, 1446 patients received HCV treatment. We included both demographic and as covariates in the multivariate logistic regression model. To control for baseline differences among treatment and control groups, propensity score matching (PSM) comparative analysis was used to adjust for potential confounding baseline characteristics between these two groups, and finally 2892 patients (1:1 match) (1446 in each group) were enrolled in the final analysis. Results: There was no statistically significant association between CVD and treatment of HCV (at both 0-12 and 12-24 months). The odds of developing CVD for females were 1.52 times greater than males during the first 12 months of treatment. Advanced age was also associated with a high risk of CVD during the initial 12 months (OR 1.05 95% CI 1.03-1.07). HCV patients with HIV were 45% less likely to experience CVD Expanded =0.55, 95% CI: 0.33- 0.91, p<0.05) compared to those without HIV for 12-24 months. Treatment’s association with the development of cardiac arrhythmias was not statistically significant between 0-12 months or 12-24 months. Older age was associated with a higher risk of cardiac arrhythmias following 0-12 months after treatment with OR 1.08 95% CI 1.04-1.12. There was also a significantly high risk of arrhythmias with hypothyroidism for 0-12 months (OR 4.23 95% CI 1.48-12.08) Conclusion: Female sex and advanced age were associated with increased odds of CVD, and advanced age and hypothyroidism were associated with increased odds of arrhythmias development during the first 12 months of treatment. Further studies are needed to explore this in a prospective fashion.