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Inicio Gastroenterología y Hepatología (English Edition) Cardiometabolic effects of direct-acting antivirals in patients with hepatitis C
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Vol. 46. Issue 1.
Pages 58-66 (January 2023)
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Vol. 46. Issue 1.
Pages 58-66 (January 2023)
Review
Cardiometabolic effects of direct-acting antivirals in patients with hepatitis C
Efectos cardiometabólicos de los antivirales de acción directa en pacientes con hepatitis C
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Georgios Neokosmidis, Adonis A. Protopapas
Corresponding author
adoprot@hotmail.com

Corresponding author.
, Dimitrios Stogiannou, Athanasios Filippidis, Konstantinos Tziomalos
First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Abstract

Hepatitis C virus (HCV) has long been associated with several extrahepatic manifestations, including increased cardiovascular risk. The emergence of direct-acting antivirals (DAAs) has allowed us to evaluate the potential reversal of these manifestations after successful treatment. Therefore, many studies have provided significant takeaways regarding the positive effect of DAAs therapy on insulin resistance, type 2 diabetes mellitus, cardiovascular disease and atherosclerosis. In contrast, studies have shown detrimental effects on lipid metabolism and indeterminate results regarding renal function and uric acid metabolism. Nevertheless, as more and more patients achieve sustained virological response, the effects of HCV eradication on cardiometabolic processes will be extensively studied, allowing more reliable conclusions on the extent of extrahepatic outcomes.

Keywords:
Direct-acting antivirals
Hepatitis C
Cardiovascular risk
Dyslipidemia
Insulin resistance
Renal function
Resumen

El virus de la hepatitis C (VHC) se ha asociado durante mucho tiempo a varias manifestaciones extrahepáticas, entre ellas el aumento del riesgo cardiovascular. La aparición de los antivirales de acción directa (AAD) ha permitido evaluar la posible reversión de estas manifestaciones tras un tratamiento exitoso. Así, muchos estudios han aportado datos significativos sobre el efecto positivo del tratamiento con AAD en la resistencia a la insulina, la diabetes mellitus de tipo 2, la enfermedad cardiovascular y la aterosclerosis. Por el contrario, los estudios han mostrado efectos perjudiciales sobre el metabolismo de los lípidos y resultados indeterminados respecto a la función renal y el metabolismo del ácido úrico. No obstante, a medida que un mayor número de pacientes logre una respuesta virológica sostenida, se estudiarán ampliamente los efectos de la erradicación del VHC sobre los procesos cardiometabólicos, lo que permitirá obtener conclusiones más fiables sobre el alcance de los resultados extrahepáticos.

Palabras clave:
Antivirales de acción directa
Hepatitis C
Riesgo cardiovascular
Dislipidemia
Resistencia a la insulina
Función renal

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