- HCV eradication with direct-acting antivirals (DAAs) is tied to significantly reduced risks for mixed cryoglobulinemia, glomerulonephritis, and lichen planus.
Why this matters
- Limited data exist on extrahepatic benefits of HCV treatment.
- Risks for non-Hodgkin's lymphoma (NHL), porphyria cutanea tarda (PCT), and diabetes remained unaffected.
- Data for 45,260 patients (mean age, 61.77 years) treated with DAAs at Veterans Affairs facilities during 2012-2016 (96.63% men, 53.78% white, 37.27% black).
- Mean follow-up, 2.01 years.
- Funding: NIH; National Institute of Diabetes and Digestive and Kidney Disease; Merck & Co., Inc., Kenilworth, NJ, USA.
- 92.2% achieved sustained virological response (SVR).
- Prevalence with SVR vs without, per 1000 person-years:
- Mixed cryoglobulinemia: 0.22 vs 0.9 (P=.0013),
- Glomerulonephritis: 2.21 vs 3.8 (P=.0055),
- PCT: 0.17 vs 0.51 (P=.0482),
- Lichen planus: 1.58 vs 3.37 (P=.0004),
- NHL: 1.88 vs 2.33 (P=.54), and
- Diabetes: 21.04 vs 23.11 (P=.53).
- Multivariate analysis tied SVR to reduced risks (adjusted HRs) for:
- Mixed cryoglobulinemia: 0.23 (P=.0012),
- Glomerulonephritis: 0.61 (P=.0126); and
- Lichen planus: 0.46 (P=.0003).
- No significant benefit was observed with respect to NHL (P=.57), diabetes (P=.86), or PCT (P=.06).
- Retrospective design.
- Homogeneous cohort.
- Limited follow-up.