Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry

ABSTRACT Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD); however, the impact of interferon (IFN)‐based therapy on cardiovascular outcomes remains unclear. This nationwide cohort study included 7411 patients with HCV from The Taiwanese Chronic H...

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Main Authors: Ping‐Jen Hu, Pei‐Chien Tsai, Chi‐Yi Chen, Hsing‐Tao Kuo, Chao‐Hung Hung, Kuo‐Chih Tseng, Hsueh‐Chou Lai, Cheng‐Yuan Peng, Jing‐Houng Wang, Jyh‐Jou Chen, Pei‐Lun Lee, Rong‐Nan Chien, Chi‐Chieh Yang, Gin‐Ho Lo, Jia‐Horng Kao, Chun‐Jen Liu, Chen‐Hua Liu, Sheng‐Lei Yan, Chun‐Yen Lin, Wei‐Wen Su, Cheng‐Hsin Chu, Chih‐Jen Chen, Shui‐Yi Tung, Chi‐Ming Tai, Chih‐Wen Lin, Ching‐Chu Lo, Pin‐Nan Cheng, Yen‐Cheng Chiu, Chia‐Chi Wang, Jin‐Shiung Cheng, Wei‐Lun Tsai, Han‐Chieh Lin, Yi‐Hsiang Huang, Ming‐Lun Yeh, Chung‐Feng Huang, Meng‐Hsuan Hsieh, Jee‐Fu Huang, Chia‐Yen Dai, Wan‐Long Chung, Yen‐Hsiange Wang, Ming‐Lung Yu, Ming‐Jong Bair, T‐COACH Study Group
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Kaohsiung Journal of Medical Sciences
Subjects:
Online Access:https://doi.org/10.1002/kjm2.70036
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author Ping‐Jen Hu
Pei‐Chien Tsai
Chi‐Yi Chen
Hsing‐Tao Kuo
Chao‐Hung Hung
Kuo‐Chih Tseng
Hsueh‐Chou Lai
Cheng‐Yuan Peng
Jing‐Houng Wang
Jyh‐Jou Chen
Pei‐Lun Lee
Rong‐Nan Chien
Chi‐Chieh Yang
Gin‐Ho Lo
Jia‐Horng Kao
Chun‐Jen Liu
Chen‐Hua Liu
Sheng‐Lei Yan
Chun‐Yen Lin
Wei‐Wen Su
Cheng‐Hsin Chu
Chih‐Jen Chen
Shui‐Yi Tung
Chi‐Ming Tai
Chih‐Wen Lin
Ching‐Chu Lo
Pin‐Nan Cheng
Yen‐Cheng Chiu
Chia‐Chi Wang
Jin‐Shiung Cheng
Wei‐Lun Tsai
Han‐Chieh Lin
Yi‐Hsiang Huang
Ming‐Lun Yeh
Chung‐Feng Huang
Meng‐Hsuan Hsieh
Jee‐Fu Huang
Chia‐Yen Dai
Wan‐Long Chung
Yen‐Hsiange Wang
Ming‐Lung Yu
Ming‐Jong Bair
T‐COACH Study Group
author_facet Ping‐Jen Hu
Pei‐Chien Tsai
Chi‐Yi Chen
Hsing‐Tao Kuo
Chao‐Hung Hung
Kuo‐Chih Tseng
Hsueh‐Chou Lai
Cheng‐Yuan Peng
Jing‐Houng Wang
Jyh‐Jou Chen
Pei‐Lun Lee
Rong‐Nan Chien
Chi‐Chieh Yang
Gin‐Ho Lo
Jia‐Horng Kao
Chun‐Jen Liu
Chen‐Hua Liu
Sheng‐Lei Yan
Chun‐Yen Lin
Wei‐Wen Su
Cheng‐Hsin Chu
Chih‐Jen Chen
Shui‐Yi Tung
Chi‐Ming Tai
Chih‐Wen Lin
Ching‐Chu Lo
Pin‐Nan Cheng
Yen‐Cheng Chiu
Chia‐Chi Wang
Jin‐Shiung Cheng
Wei‐Lun Tsai
Han‐Chieh Lin
Yi‐Hsiang Huang
Ming‐Lun Yeh
Chung‐Feng Huang
Meng‐Hsuan Hsieh
Jee‐Fu Huang
Chia‐Yen Dai
Wan‐Long Chung
Yen‐Hsiange Wang
Ming‐Lung Yu
Ming‐Jong Bair
T‐COACH Study Group
author_sort Ping‐Jen Hu
collection DOAJ
description ABSTRACT Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD); however, the impact of interferon (IFN)‐based therapy on cardiovascular outcomes remains unclear. This nationwide cohort study included 7411 patients with HCV from The Taiwanese Chronic Hepatitis C Cohort registry who received IFN‐based therapy between 2003 and 2014. Patients were categorized into sustained virological response (SVR) (n = 5785) and non‐SVR (n = 1676) groups. The incidence of new‐onset CVD events, including stroke, coronary artery disease, heart failure, and arrhythmia, was assessed using three Cox proportional hazard models adjusted for different sets of confounding factors. The cumulative CVD incidence was comparable in the SVR and non‐SVR groups (11.2% vs. 10.2%, p = 0.609). SVR was not significantly associated with a reduced overall CVD risk among the three models [hazards ratio (HR) = 0.88, 95% confidence interval (CI): 0.71–1.05, p = 0.158]. However, a lower risk of stroke was observed in patients who achieved an SVR, although the difference was not significant (HR = 0.84, 95% CI: 0.74–0.94). The results of the sensitivity analyses confirmed these findings. An SVR following IFN‐based therapy did not substantially reduce the overall CVD risk; however, a potential reduction in stroke risk was observed. These results emphasize the importance of long‐term cardiovascular risk assessments and highlight the need for further research, particularly in the direct‐acting antiviral era in which increased cardiovascular benefits may be expected.
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spelling doaj-art-9d93bf7968b14c65b9539136f00dd48e2025-08-21T04:28:12ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502025-08-01418n/an/a10.1002/kjm2.70036Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus RegistryPing‐Jen Hu0Pei‐Chien Tsai1Chi‐Yi Chen2Hsing‐Tao Kuo3Chao‐Hung Hung4Kuo‐Chih Tseng5Hsueh‐Chou Lai6Cheng‐Yuan Peng7Jing‐Houng Wang8Jyh‐Jou Chen9Pei‐Lun Lee10Rong‐Nan Chien11Chi‐Chieh Yang12Gin‐Ho Lo13Jia‐Horng Kao14Chun‐Jen Liu15Chen‐Hua Liu16Sheng‐Lei Yan17Chun‐Yen Lin18Wei‐Wen Su19Cheng‐Hsin Chu20Chih‐Jen Chen21Shui‐Yi Tung22Chi‐Ming Tai23Chih‐Wen Lin24Ching‐Chu Lo25Pin‐Nan Cheng26Yen‐Cheng Chiu27Chia‐Chi Wang28Jin‐Shiung Cheng29Wei‐Lun Tsai30Han‐Chieh Lin31Yi‐Hsiang Huang32Ming‐Lun Yeh33Chung‐Feng Huang34Meng‐Hsuan Hsieh35Jee‐Fu Huang36Chia‐Yen Dai37Wan‐Long Chung38Yen‐Hsiange Wang39Ming‐Lung Yu40Ming‐Jong Bair41T‐COACH Study GroupDepartment of Internal Medicine, Division of Gastroenterology Shuang Ho Hospital, Taipei Medical University New Taipei City TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanDepartment of Internal Medicine Chiayi Christian Hospital Chiayi TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine Chi‐Mei Medical Center Tainan TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine Chiayi Chang Gung Memorial Hospital Chiayi TaiwanDepartment of Gastroenterology Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Chiayi TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine China Medical University Hospital Taichung TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine China Medical University Hospital Taichung TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung TaiwanDivision of Gastroenterology and Hepatology Chi‐Mei Medical Center Tainan TaiwanDivision of Gastroenterology and Hepatology Chi‐Mei Medical Center Tainan TaiwanDivision of Hepatology, Department of Gastroenterology and Hepatology Linkou Medical Center, Chang Gung Memorial Hospital Keelung TaiwanDivision of Gastroenterology, Department of Internal Medicine Show Chwan Memorial Hospital Changhua TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine E‐Da Hospital, I‐Shou University Kaohsiung TaiwanGraduate Institute of Clinical Medicine, National Taiwan University College of Medicine Taipei TaiwanGraduate Institute of Clinical Medicine, National Taiwan University College of Medicine Taipei TaiwanGraduate Institute of Clinical Medicine, National Taiwan University College of Medicine Taipei TaiwanDivision of Gastroenterology, Department of Internal Medicine Chang Bing Show‐Chwan Memorial Hospital Changhua TaiwanDivision of Hepatology, Department of Gastroenterology and Hepatology Linkou Medical Center, Chang Gung Memorial Hospital Keelung TaiwanDivision of Gastroenterology, Department of Internal Medicine Changhua Christian Hospital Changhua TaiwanDivision of Gastroenterology, Department of Internal Medicine MacKay Memorial Hospital Taipei TaiwanDivision of Gastroenterology, Department of Internal Medicine MacKay Memorial Hospital Taipei TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine China Medical University Hospital Taichung TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine E‐Da Hospital, I‐Shou University Kaohsiung TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine E‐Da Hospital, I‐Shou University Kaohsiung TaiwanDepartment of Internal Medicine St. Martin De Porres Hospital–Daya Chiayi TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan TaiwanDivision of Gastroenterology, Department of Internal Medicine Taipei Tzuchi Hospital, the Buddhist Tzuchi Medical Foundation New Taipei TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine Kaohsiung Veterans General Hospital Kaohsiung TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine Kaohsiung Veterans General Hospital Kaohsiung TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine Taipei TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine Taipei TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanSchool of Medicine, College of Medicine Taipei Medical University Taipei TaiwanHepatobiliary Section, Department of Internal Medicine, and Hepatitis Center Kaohsiung Medical University Hospital; Hepatitis Research Center, School of Medicine and Cohort Research Center, Kaohsiung Medical University Kaohsiung TaiwanDivision of Gastroenterology, Department of Internal Medicine Taitung Mackay Memorial Hospital Taipei TaiwanABSTRACT Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD); however, the impact of interferon (IFN)‐based therapy on cardiovascular outcomes remains unclear. This nationwide cohort study included 7411 patients with HCV from The Taiwanese Chronic Hepatitis C Cohort registry who received IFN‐based therapy between 2003 and 2014. Patients were categorized into sustained virological response (SVR) (n = 5785) and non‐SVR (n = 1676) groups. The incidence of new‐onset CVD events, including stroke, coronary artery disease, heart failure, and arrhythmia, was assessed using three Cox proportional hazard models adjusted for different sets of confounding factors. The cumulative CVD incidence was comparable in the SVR and non‐SVR groups (11.2% vs. 10.2%, p = 0.609). SVR was not significantly associated with a reduced overall CVD risk among the three models [hazards ratio (HR) = 0.88, 95% confidence interval (CI): 0.71–1.05, p = 0.158]. However, a lower risk of stroke was observed in patients who achieved an SVR, although the difference was not significant (HR = 0.84, 95% CI: 0.74–0.94). The results of the sensitivity analyses confirmed these findings. An SVR following IFN‐based therapy did not substantially reduce the overall CVD risk; however, a potential reduction in stroke risk was observed. These results emphasize the importance of long‐term cardiovascular risk assessments and highlight the need for further research, particularly in the direct‐acting antiviral era in which increased cardiovascular benefits may be expected.https://doi.org/10.1002/kjm2.70036cardiovascular diseasehepatitis Cinterferon therapystrokesustained virologic response
spellingShingle Ping‐Jen Hu
Pei‐Chien Tsai
Chi‐Yi Chen
Hsing‐Tao Kuo
Chao‐Hung Hung
Kuo‐Chih Tseng
Hsueh‐Chou Lai
Cheng‐Yuan Peng
Jing‐Houng Wang
Jyh‐Jou Chen
Pei‐Lun Lee
Rong‐Nan Chien
Chi‐Chieh Yang
Gin‐Ho Lo
Jia‐Horng Kao
Chun‐Jen Liu
Chen‐Hua Liu
Sheng‐Lei Yan
Chun‐Yen Lin
Wei‐Wen Su
Cheng‐Hsin Chu
Chih‐Jen Chen
Shui‐Yi Tung
Chi‐Ming Tai
Chih‐Wen Lin
Ching‐Chu Lo
Pin‐Nan Cheng
Yen‐Cheng Chiu
Chia‐Chi Wang
Jin‐Shiung Cheng
Wei‐Lun Tsai
Han‐Chieh Lin
Yi‐Hsiang Huang
Ming‐Lun Yeh
Chung‐Feng Huang
Meng‐Hsuan Hsieh
Jee‐Fu Huang
Chia‐Yen Dai
Wan‐Long Chung
Yen‐Hsiange Wang
Ming‐Lung Yu
Ming‐Jong Bair
T‐COACH Study Group
Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry
Kaohsiung Journal of Medical Sciences
cardiovascular disease
hepatitis C
interferon therapy
stroke
sustained virologic response
title Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry
title_full Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry
title_fullStr Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry
title_full_unstemmed Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry
title_short Impact of Hepatitis C Virus Clearance on Cardiovascular Risk: A Real‐World Experience From the Nationwide Taiwan Hepatitis C Virus Registry
title_sort impact of hepatitis c virus clearance on cardiovascular risk a real world experience from the nationwide taiwan hepatitis c virus registry
topic cardiovascular disease
hepatitis C
interferon therapy
stroke
sustained virologic response
url https://doi.org/10.1002/kjm2.70036
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