• Di Minno Matteo Nicola Dario MND 0000-0001-8059-3819 Department of Translational Medical Sciences, Federico II University, Via S. Pansini 5, 80131, Na, Pasquale Ambrosino, Antonio Riccardo Buonomo, Biagio Pinchera, Ilenia Calcaterra, Manuel Crispo, Riccardo Scotto, Francesco Borgia, Consalvo Mattia, and Ivan Gentile.
• Department of Translational Medical Sciences, Federico II University, Via S. Pansini 5, 80131, Naples, Italy. dario.diminno@hotmail.it.
• Intern Emerg Med. 2020 Mar 1; 15 (2): 263-271.

AbstractHepatitis C virus (HCV) infection is associated with increased cardiovascular risk. We evaluated effects of direct-acting antiviral agents (DAAs) on flow-mediated dilation (FMD), a recognized marker of cardiovascular risk. We evaluated FMD and post-ischemic hyperemia (PIH) in consecutive HCV out-patients before starting DAAs, at the end of treatment (Teot) and 12 weeks thereafter. In 22 HCV subjects (age 64.0 years), baseline FMD was 4.52% ± 1.90 and PIH of 5814.4 (IQR 3786.9-7861.9). At (Teot), all patients showed undetectable levels of HCV-RNA and FMD changed from 4.52% ± 1.90 to 9.39% ± 4.06 (p < 0.001), with a direct correlation between changes in FMD and baseline HCV-RNA levels (r = 0.494, p = 0.020). In parallel, PIH increased from 5814.4 (IQR 3786.9-7861.9) to 7277.6 (IQR 4579.8-10388.8) (p = 0.019). Twelve weeks after Teot, all patients had persistently negative HCV-RNA, FMD was 10.9% ± 4.65 and PIH was 10930.3 (IQR 6254.6-18248.2) suggesting a further significant improvement in these parameters. Results remained significant regardless of the presence of cardiovascular risk factors, whereas FMD changes were not statistically significant in subjects with cirrhosis. A persistent and significant improvement in endothelial function is observed in HCV patients obtaining viral eradication with DAAs treatment. This might suggest a beneficial effect of DAAs treatment on cardiovascular risk profile of HCV patients.

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