Increased Risk of Intracerebral Hemorrhage Among Patients With Hepatitis C Virus Infection

Tseng, Chun Hung; Muo, Chih Hsin; Hsu, Chung Y.; Kao, Chia Hung

doi:10.1097/md.0000000000002132

Cited by 20 publications

(20 citation statements)

References 30 publications

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“…Worryingly, some studies also suggested a significant association between HCV and cerebral hemorrhages[192,193], and a recent large Taiwanese cohort study extended the association between HCV and atherosclerosis by showing that HCV-infected patients had an increased risk of peripheral artery disease compared to non-HCV control subjects[194]. …”

Section: Hcv Infectionmentioning

confidence: 99%

Fatty liver is associated with an increased risk of diabetes and cardiovascular disease - Evidence from three different disease models: NAFLD, HCV and HIV

Lonardo¹,

Ballestri²,

Guaraldi³

et al. 2016

WJG

101

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Fatty liver, which frequently coexists with necro-inflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease (NAFLD) and chronic infections due to either hepatitis C virus (HCV) or human immunodeficiency virus (HIV). These three pathologic conditions are associated with an increased prevalence and incidence of cardiovascular disease (CVD) and type 2 diabetes (T2D). In this multidisciplinary clinical review, we aim to discuss the ever-expanding wealth of clinical and epidemiological evidence supporting a key role of fatty liver in the development of T2D and CVD in patients with NAFLD and in those with HCV or HIV infections. For each of these three common diseases, the epidemiological features, pathophysiologic mechanisms and clinical implications of the presence of fatty liver in predicting the risk of incident T2D and CVD are examined in depth. Collectively, the data discussed in this updated review, which follows an innovative comparative approach, further reinforce the conclusion that the presence of fatty/inflamed/fibrotic liver might be a shared important determinant for the development of T2D and CVD in patients with NAFLD, HCV or HIV. This review may also open new avenues in the clinical and research arenas and paves the way for the planning of future, well-designed prospective and intervention studies.

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Section: Hcv Infectionmentioning

confidence: 99%

Fatty liver is associated with an increased risk of diabetes and cardiovascular disease - Evidence from three different disease models: NAFLD, HCV and HIV

Lonardo¹,

Ballestri²,

Guaraldi³

et al. 2016

WJG

101

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“…Two cases of intracranial hemorrhage were found only in first group’s patients. Intracranial hemorrhage was also reported before in untreated hepatitis C patients[ 35 , 36 ], but no evidence of ICH with pegIFN plus RBV was seen previously. In our findings ICH may also be due to HCV not because of SOF that needs further studies on a large scale.…”

Section: Discussionmentioning

confidence: 65%

Dramatic response of hepatitis C patients chronically infected with hepatitis C virus genotype 3 to sofosbuvir-based therapies in Punjab, Pakistan: A prospective study

Iqbal¹,

Yousuf²,

Yousaf³

2017

WJG

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AIMTo prospectively evaluate the efficacy of sofobuvir (SOF) in hepatitis C patients infected with hepatitis C virus (HCV) genotype 3 in Pakistan.METHODSThe present study was performed with the coordination of gastroenterology and pathology departments of Shalamar Hospital Lahore from August 2014 to May 2016. The total number of patients included in this study was 1375 and all of them were infected with HCV genotype 3. On the basis of drug combinations, all the patients were separated into two groups. The first group of patients was treated for 24 wk with SOF (Sovaldi® by Gilead Sciences) plus ribavirin (RBV) [Ribazol® by Getz Pharma Pakistan (PVT) Ltd], while the patients of the second group were treated with SOF + RBV + pegylated-interferon (pegIFN) alfa-2a (Ropegra by Roach) for 12 wk. HCV genotyping and viral load measurement were performed on fully automated Abbott Real-Time PCR system (Abbott m24sp automated nucleic acid extraction system and Abbott m2000rt amplification system; abbott Molecular, Des Plaines, IL, United States). For the assessment of sustained virological response (SVR), all HCV RNA negative patients were followed for 12 weeks after the treatment completion. Any patient with less than 12 IU/mL viral load after 12 wk of treatment completion was considered as a sustained virological responder (SVR-12).RESULTSA total of 1375 patients chronically infected with HCV genotype 3 were treated with two drug combinations SOF + RBV and SOF + RBV + pegIFN alfa-2a. On the basis of these drug combinations, patients were divided into two groups (first and second). Overall SVR-12 was excellent in both groups (99.17% and 97.91%). Older patients (> 40 years) of second group showed lower SVR-12 (93.46%) compared to first group older patients (98.79%), while in the younger patients of both groups, the SVR-12 rate was almost the same (99.54% in first group and 99.05% in second group). No such difference regarding SVR-12 rate was seen in males and females of first group patients (99.68% and 98.88%, respectively), while in second group the males were found to be better responders compared to females (98.96% and 95%). The SVR-12 rate in previously treated patients of first group was better (99.34%) than second group (93.70%), while naïve patients of second group were marginally better responders (99.25%) than first group (97.80%). Rapid viral response at week-4 was found to be a very effective predictor for assessing the SVR rate at this stage of therapy in both groups. Headache, anemia and fatigue were common side effects in both groups either treated with SOF + RBV or SOF + RBV + pegIFN alfa-2a, while the overall percentage of the side effects was higher in second group.CONCLUSIONThe remarkable SVR response rate of HCV genotype 3 infected patients to SOF provided a new way to look forward to eliminate hepatitis C from our region.

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“…However, their study lacked renal function data before IBT and background matching between cohorts. Despite conventional factors like age, being male, smoking, hypertension, diabetes, and drinking alcohol [ 23 ], HCV contributed to hemorrhagic stroke [ 24 , 25 ], liver cirrhosis [ 26 – 28 ], and unstable hemostasis [ 29 ]. Moreover, HCV was critically involved in systemic atherosclerosis, vascular remodeling, ectasia change, and microaneurysms, which manifested as cerebral microbleeds (CMBs) in the MRIs of patients with advanced hepatic fibrosis [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Add-on neurological benefits of antiviral therapy in HCV patients with chronic kidney disease — a nationwide cohort study

et al. 2017

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BackgroundHepatitis C virus (HCV)-infected patients with chronic kidney disease (CKD) have rarely been studied because they rarely accept interferon-based therapy (IBT) and have been difficult to follow up. We investigated long-term outcomes of IBT on the population.MethodsThis population-based cohort study used the Taiwan National Health Insurance Research Database as its data source. HCV patients diagnosed with CKD between Jan. 1, 2003, and Dec. 31, 2013, were selected. They were then divided into two groups based on whether they had undergone IBT. All-cause mortality, acute myocardial infarction (AMI), ischemic stroke (IS), hemorrhagic stroke, and new-onset dialysis were evaluated using a Cox proportional hazard regression analysis after propensity score matching.ResultsWe enrolled 9872 HCV patients with CKD: 1684 patients in the treated cohort and 8188 patients in the untreated cohort. The annual incidence of all-cause mortality (19.00 vs. 42.89 events per 1000 person-years; p < 0.001) and the incidences of hemorrhagic stroke (1.21 vs. 4.19 events per 1000 person-years; p = 0.006) were lower in the treated cohort. New-onset dialysis was also lower in the treated cohort (aHR: 0.31; 95% CI: 0.20–0.48; p < 0.001).ConclusionAntiviral therapy might provide protective benefits on all-cause mortality, hemorrhagic stroke, and new-onset dialysis in HCV-infected patients with CKD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-017-0653-2) contains supplementary material, which is available to authorized users.

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Increased Risk of Intracerebral Hemorrhage Among Patients With Hepatitis C Virus Infection

Cited by 20 publications

References 30 publications

Fatty liver is associated with an increased risk of diabetes and cardiovascular disease - Evidence from three different disease models: NAFLD, HCV and HIV

Fatty liver is associated with an increased risk of diabetes and cardiovascular disease - Evidence from three different disease models: NAFLD, HCV and HIV

Dramatic response of hepatitis C patients chronically infected with hepatitis C virus genotype 3 to sofosbuvir-based therapies in Punjab, Pakistan: A prospective study

Add-on neurological benefits of antiviral therapy in HCV patients with chronic kidney disease — a nationwide cohort study

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