JAMA Netw Open

Direct-acting antivirals linked to broader health benefits in HCV

June 13, 2025

Study details: This large, population-based retrospective cohort study from British Columbia, Canada, included 22,576 adults with chronic HCV infection, comparing those who achieved sustained virologic response (SVR) after direct-acting antiviral (DAA) therapy to untreated individuals. Median follow-up was 2.5 years, and outcomes were adjusted using inverse probability of treatment weighting to account for baseline differences.

Results: Patients who achieved SVR with DAAs had significantly lower incidence rates of chronic kidney disease/end-stage kidney disease (CKD/ESKD), stroke, major adverse cardiac events (MACE), and neurocognitive disorders (NCD) compared with untreated patients. Adjusted cause-specific hazard ratios (acsHR) for DAA-treated vs. untreated were: CKD/ESKD 0.54 (95% confidence interval [CI], 0.47-0.63), stroke 0.66 (95% CI, 0.54-0.81), MACE 0.58 (95% CI, 0.52-0.66), and NCD 0.52 (95% CI, 0.45-0.61). No significant reduction was observed for T2DM (acsHR 1.04; 95% CI, 0.84-1.29).

Clinical impact: These findings reinforce the importance of early HCV screening and prompt initiation of DAA therapy to prevent extrahepatic complications and improve long-term outcomes in chronic HCV infection.

Source:

Jeong D, et al. (2025, June 2). JAMA Netw Open. Direct-Acting Antivirals and Risk of Hepatitis C Extrahepatic Manifestations. https://pubmed.ncbi.nlm.nih.gov/40498486/