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Cuciureanu T, Stanciu C, Năstasă RR, Stratina LE, Minea HO, Zenovia IS, Sfarti C, Muzica CM, Huiban L, Stafie RT, Singeap AM, Chiriac Ş, Cojocariu EC, Gîrleanu I, Petrea OC, Timofeiov S, Cuciureanu ID, Rotaru A, Trifan A. Improvement of carotid atherosclerosis and peripheral artery disease after hepatitis C virus eradication by direct-acting antivirals. Rom J Morphol Embryol 2023; 64:483-491. [PMID: 38184828 PMCID: PMC10863684 DOI: 10.47162/rjme.64.4.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Recent research points to a link between chronic hepatitis C virus (HCV) infection and cardiovascular disease, especially carotid atherosclerosis, and suggests that HCV clearance may impact cardiovascular outcomes. AIM To determine if viral eradication by the new oral direct-acting antiviral (DAA) agents has benefit regarding carotid atherosclerosis, peripheral artery disease (PAD), steatosis, and liver fibrosis. PATIENTS, MATERIALS AND METHODS We conducted a prospective study on 168 patients diagnosed with chronic HCV infection or HCV-related cirrhosis. They were all treated with DAAs, with sustained virological response (SVR). Laboratory data, vibration-controlled transient elastography (VCTE), carotid intima-media thickness (IMT) measurement, and ankle-brachial index (ABI) were recorded in all patients. RESULTS We found an average IMT of 1.22±0.2 mm, with a variance range from 1.14±0.19 mm in the mild and moderate fibrosis (≤F2) group to 1.29±0.25 mm in the severe fibrosis (≥F3) group. Also, patients with severe fibrosis (≥F3) present a more critical decrease of IMT values, with the carotid thickness affecting only 18.2% of individuals in the follow-up period. At the baseline, the best values of ABI were recorded in patients having F1-F2 fibrosis stage (mean value 1.02±0.19). Instead, in the group with severe fibrosis, the average value of ABI was lower (0.91±0.16) at the baseline, with a significant increase at SVR evaluation (p<0.001). CONCLUSIONS Our research highlights the beneficial effect of viral eradication on both carotid atherosclerosis and PAD, especially in those with advanced fibrosis and cirrhosis.
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Affiliation(s)
- Tudor Cuciureanu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Carol Stanciu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
- Biomedical Research Center, Romanian Academy, Iaşi Subsidiary, Romania
| | - Robert Radu Năstasă
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Larisa Ermina Stratina
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Horia Octav Minea
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Ioan Sebastian Zenovia
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Cătălin Sfarti
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Cristina Maria Muzica
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Laura Huiban
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Remus Theodor Stafie
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Ana-Maria Singeap
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Ştefan Chiriac
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Eliza Camelia Cojocariu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Irina Gîrleanu
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Oana Cristina Petrea
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Sergiu Timofeiov
- Department of Surgery, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Department of Surgery, St. Spiridon University Hospital, Iaşi, Romania
| | - Iulian Dan Cuciureanu
- Department of Neurology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Department of Neurology, Prof. Dr. Nicolae Oblu University Hospital, Iaşi, Romania
| | - Adrian Rotaru
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
| | - Anca Trifan
- Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania
- Institute of Gastroenterology and Hepatology, St. Spiridon University Hospital, Iaşi, Romania
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