Published online Nov 7, 2018. doi: 10.3748/wjg.v24.i41.4617
Peer-review started: August 19, 2018
First decision: October 9, 2018
Revised: October 11, 2018
Accepted: October 21, 2018
Article in press: October 21, 2018
Published online: November 7, 2018
Core tip: Chronic hepatitis C (HCV) infection is associated with an increased risk of atherosclerosis, cardiovascular disease and cardiovascular mortality. HCV lives within carotid plaques, promotes pro-atherogenic conditions such as pro-inflammatory cytokines, oxidative stress, insulin resistance, diabetes, steatosis, cryoglobulinemia and endotoxinemia. Direct-acting antiviral agents (DAA) are highly effective and safe therapeutic regimens. There are a number of studies showing that HCV clearance by DAAs is associated with an improvement in atherosclerosis and a reduced risk of cardiovascular events. In addition, HCV clearance is associated with improvement of metabolic and immunological conditions that promote cardiovascular disease. Further studies will be needed to confirm these promising data.