Chronic hepatitis C virus infection is associated with several extrahepatic manifestations.
Data on the effect of sustained virological response on the risk of extrahepatic manifestations are limited.
Dr Parag Mahale and colleagues of Maryland, USA conducted a retrospective cohort study using data of patients from the United States veterans affairs hepatitis C virus clinical case registry who had a positive hepatitis C virus RNA test.
Patients receiving interferon-based antiviral therapy were identified.
Sustained virological response was defined as negative hepatitis C virus RNA at least 12 weeks after end of antiviral therapy.
antiviral therapy, of whom 10,575 experienced sustained virological
Risks of 8 incident extrahepatic manifestations were evaluated in Cox regression models.
Of the 160,875 hepatitis C virus-infected veterans, 31,143 received antiviral therapy, of whom 10,575 experienced sustained virological response.
The researchers found that the extrahepatic manifestations risk was reduced in the sustained virological response group compared with untreated patients for mixed cryoglobulinemia, glomerulonephritis, porphyria cutanea tarda, non-Hodgkin’s lymphoma, diabetes and stroke, but not for lichen planus or coronary heart disease.
Risk reductions were also observed when patients with sustained virological response were compared with treated patients without sustained virological response for mixed cryoglobulinemia, glomerulonephritis, porphyria cutanea tarda and diabetes.
The team saw significant reductions in the magnitude of aHRs towards the null with increasing time to initiation of antiviral therapy after hepatitis C virus diagnosis were observed for glomerulonephritis, non-Hodgkin’s lymphoma and stroke.
Dr Mahale's team comments, "Risks of several extrahepatic manifestations of hepatitis C virus infection are reduced after antiviral therapy with sustained virological response."
"However, early initiation of antiviral therapy may be required to reduce the risk of glomerulonephritis, non-Hodgkin’s lymphoma and stroke."