Changes in cardiometabolic biomarkers 1 year after direct acting antiviral therapy for hepatitis C virus co‐infection among people with HIV

OBJECTIVES: Among people with HIV with hepatitis C virus (HCV) co-infection, we examined differences in haemoglobin A1c (HbA1c), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and atherosclerotic cardiovascular disease (ASCVD) risk score at 12-months following direct acting antiviral (DAA) initiation, comparing people with HIV who initiated DAA with those who did not to explore the utility of DAAs beyond HCV elimination. METHODS: Utilizing a nested exposure-matched study of people with HIV age ≥ 18 years, on antiretroviral therapy from the NA-ACCORD and the Mass General Brigham HIV cohorts between 01/1/2014 and 12/31/2022, people with HIV with HCV co-infection were identified by detectable plasma HCV RNA. People with HIV who initiated DAA were matched 1:1 with people with HIV who did not initiate DAA. Multivariable linear regression models estimated HbA1c (N = 2374), TC (N = 3418) and ASCVD risk score (N = 488) at 12-months comparing people with HIV who initiated DAAs versus did not. RESULTS: We identified no significant difference in the mean HbA1c at 12-months comparing DAA initiators to DAA non-initiators (β: 0.00%, 95% confidence interval [CI] -0.09% to 0.08%). The mean TC at 12-months was 13 mg/dL (95% CI 11-16 mg/dL) higher in DAA initiators and largely due to increases in LDL. There was no significant difference in the mean ASCVD risk score at 12-months when comparing DAA initiators with those who did not initiate DAAs (β: 1.10, 95% CI -0.09 to 2.20). CONCLUSION: People with HIV with HCV who initiated DAA demonstrated no statistically significant difference in HbA1c or ASCVD risk score at 12-months compared to HIV/HCV co-infected persons who did no initiate DAA. However, TC and LDL levels increased 12 months following DAA treatment.

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UNC Libraries
Published
2026-10-29
DOI
https://doi.org/10.17615/mfdx-4030
Primary Topic
Hepatitis C virus research
Type
article
Field-Weighted Citation Impact
0.00

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article

Changes in cardiometabolic biomarkers 1 year after direct acting antiviral therapy for hepatitis C virus co‐infection among people with HIV

Arthur Y. Kim, Virginia A. Triant, Raynell Lang, Leila H. Borowsky et al.
1 links
UNC Libraries
Hepatitis C virus research
article

Changes in cardiometabolic biomarkers 1 year after direct acting antiviral therapy for hepatitis C virus co‐infection among people with HIV

Arthur Y. Kim, Virginia A. Triant, Raynell Lang, Leila H. Borowsky, Keri N. Althoff, Elizabeth Humes, Sonia Napravnik, Jennifer O. Lam, Richard D. Moore, Asya Lyass, Ditipriya Bhar, Frank Palella, Michael LaValley, Heidi Crane, Brenna Hogan, North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS, Michael Horberg
article en

Abstract

OBJECTIVES: Among people with HIV with hepatitis C virus (HCV) co-infection, we examined differences in haemoglobin A1c (HbA1c), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and atherosclerotic cardiovascular disease (ASCVD) risk score at 12-months following direct acting antiviral (DAA) initiation, comparing people with HIV who initiated DAA with those who did not to explore the utility of DAAs beyond HCV elimination. METHODS: Utilizing a nested exposure-matched study of people with HIV age ≥ 18 years, on antiretroviral therapy from the NA-ACCORD and the Mass General Brigham HIV cohorts between 01/1/2014 and 12/31/2022, people with HIV with HCV co-infection were identified by detectable plasma HCV RNA. People with HIV who initiated DAA were matched 1:1 with people with HIV who did not initiate DAA. Multivariable linear regression models estimated HbA1c (N = 2374), TC (N = 3418) and ASCVD risk score (N = 488) at 12-months comparing people with HIV who initiated DAAs versus did not. RESULTS: We identified no significant difference in the mean HbA1c at 12-months comparing DAA initiators to DAA non-initiators (β: 0.00%, 95% confidence interval [CI] -0.09% to 0.08%). The mean TC at 12-months was 13 mg/dL (95% CI 11-16 mg/dL) higher in DAA initiators and largely due to increases in LDL. There was no significant difference in the mean ASCVD risk score at 12-months when comparing DAA initiators with those who did not initiate DAAs (β: 1.10, 95% CI -0.09 to 2.20). CONCLUSION: People with HIV with HCV who initiated DAA demonstrated no statistically significant difference in HbA1c or ASCVD risk score at 12-months compared to HIV/HCV co-infected persons who did no initiate DAA. However, TC and LDL levels increased 12 months following DAA treatment.

UNC Libraries
University of North Carolina at Chapel Hill (US)
Health Resources and Services Administration, Agency for Healthcare Research and Quality, Canadian Institutes of Health Research, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, National Human Genome Research Institute, National Eye Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Dental and Craniofacial Research, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Good health and well-being
Openalex Percentile: Top 14%
Hepatitis C virus research
DOIOpen Access PDFOpenAlex
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