Copyright ©The Author(s) 2021.
World J Gastroenterol. May 7, 2021; 27(17): 1959-1972
Published online May 7, 2021. doi: 10.3748/wjg.v27.i17.1959
Table 1 Summary of studies investigated cardiometabolic manifestations of chronic hepatitis C after viral cure
Antiviral regimen
The studied HCV-associated cardiometabolic manifestations
Post SVR outcomes
Fernández-Rodríguez et al[28], 2006NA1Lipid disturbances. Hepatic steatosisHypercholesterolemia in patients with genotype 3
No change in genotype 3 non-responders and in patients with genotype 1 regardless of response
Decrease in steatosis
Giordanino et al[71], 2008IFN monotherapy or Peg-IFN + RBV (24-48 wk)Glucose abnormalities (IFG or DM)No significant reduction in the risk of glucose intolerance in long-term responders and non-responders
Arase et al[70], 2009IFN monotherapy or IFN + RBV2DM Decreased incidence of DM in sustained responders. However, its development is associated with advanced liver disease
Corey et al[18], 2009NA1Lipid abnormalitiesIncreased LDL and total cholesterol from baseline compared to non-responders
Risk of CVDIncreased CVD risk profile
Conjeevaram et al[67], 2011Peg-IFN + RBV (24-48 wk)IRDecreased IR
ObesityDecreased in BMI
Kuo et al[27], 2011Peg-IFN + RBV (24 wk)Change in serum lipidTotal cholesterol and triglycerides levels significantly increased
No evident change in lipid profile occurred in non-SVR group
Aghemo et al[68], 2012Peg-IFN + RBV2IR in non-diabetic CHC patients Baseline and posttreatment HOMA-IR values were similar in SVR patients
Significant increase in HOMA-IR was noted in non-SVR patients
Clark et al[25], 2012 Albinterferon α-2b + RBVLipid abnormalities in genotypes 2,3Hypercholesterolemia
Thompson et al[66], 2012Albinterferon α-2b vs Peg-IFN + RBV (24-48 wk)IR in genotypes 1,2,3Reduced IR in genotype 1 responders
No change in genotype 1 non-responders and genotype 2 and 3 regardless of the response
Chang et al[29], 2014eg-IFN + RBV (24/48 wk)Lipids and IR in genotypes 2, 3Increased total cholesterol and triglycerides in sustained responders
Decreased HOMA-IR in patients with SVR and baseline IR
High HOMA-IR was found in patients without baseline IR (only in genotype 1)
Hsu et al[88], 2015Peg-IFN + RBV (16-48 wk)Acute coronary syndrome and ischemic strokeImprovement in both studied circulatory outcomes
Innes et al[89], 2015NA1CVDReduced hazard and absolute risk for CVD
Meissner et al[24], 2015SOF + RBV (24 wk)Lipid disturbances in genotype 1Increased LDL level and particle size and decreased triglycerides concentration and VLDL particle size irrespective to treatment response
Increased intrahepatic lipid-related genes in sustained responders
Leone et al[72], 2016IFN-based regimenDM and CVDNo significant risk reduction in DM and CVD in SVR group as opposed to non SVR
Yair-Sabag et al[39], 2016Peg-IFN + RBV (24-48 wk)IFG and DM. Triglycerides. Hepatic steatosisLower IFG and DM, and higher triglycerides in sustained responders
Improvement in hepatic steatosis
Chang et al[16], 2017NA1Cardiovascular complicationsAn increased adipokine PAI-1 in SVR group, which accelerates cardiovascular risk, especially in vulnerable cases
Mahale et al[69], 2018IFN-based regimen2DM and CVDAntiviral therapy associated with lower risk of DM and stroke whereas no significant effect on CVD
Nahon et al[90], 2017Peg-IFN + RBV (16-48 wk) or combination therapies3CVDLower risk of CVD in SVR subjects in comparison to non SVR
Stine et al[74], 2017DAAs2,3DM in genotypes 1, 2, 3Glycosylated hemoglobin was not affected in known diabetic patients
1/3 of patients required escalation of anti-diabetic therapy during antiviral treatment
Carvalho et al[11], 2018SOF + LDV ± RBV (group 1) vs Peg-IFN + RBV (group 2)Lipid levels. Serum glucose. IRWhile total cholesterol increased in both groups, triglycerides levels decreased in group 1 and increased in group 2
LDL elevated in group 1 and No change in group 2
No significant variation in serum glucose
Significant increase in HOMA-IR only in group 2
Kawagishi et al[17], 2018DAAs3Hepatic steatosis. Lipid abnormalitiesDecrease in CAP and LDL in patients with high baseline values
Elevated sdLDL in patients who had dyslipidemia and hepatic steatosis at 24 wk
Li et al[73], 2018DAAs4DM Lower risk of DM in SVR patients than in treatment failure group
Noureddin et al[46], 2018DAAs3Hepatic steatosis and fibrosisHigh prevalence of fatty liver
Although fibrosis has been reduced in patients with and without steatosis compared to baseline, patients with steatosis continued to have clinically significant liver stiffness
Li et al[10], 2019IFN + RBV (48 wk)Serum glucose level and IRReduced glucose level
Improved IR
Butt et al[87], 2019IFN + RBV2,3. DAAs2,3CVD Lower incidence in treatment group, compared to controls
DAAs showed greater risk reduction than interferon-based regimen
SVR associated with decreased CVD risk
Abdo et al[75], 2020SOF + DCV (12-24 wk)Glycemic status, IR, and lipid profile in CHC patients with DMImprovement of glycemic state and HOMA-IR
Global worsening of lipid profile
Graf et al[45], 2020DAAs3IR, lipid perturbations, body weight changes, and hepatic steatosis Lower HOMA-IR compared to baseline
Higher total cholesterol, LDL, and HDL
Higher CAP relative to baseline
BMI did not significantly change over time
Huang et al[31], 2020DAAs4Lipids and cardiovascular eventsIncreased total cholesterol and LDL
Higher cardio-cerebral diseases