1. Antiviral Treatment and Response are Associated With Lower Risk of Dementia Among Hepatitis C Virus-Infected Patients.
- Author
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Tao, Meng-Hua, Gordon, Stuart C., Wu, Trueman, Trudeau, Sheri, Rupp, Loralee B., Gonzalez, Humberto C., Daida, Yihe G., Schmidt, Mark A., and Lu, Mei
- Abstract
• What is the primary question addressed by this study? Are hepatitis C antiviral treatments associated with risk of dementia among patients with hepatitis C virus? • What is the main finding of this study? This study found that hepatitis C-infected patients who achieved sustained virological response had significantly decreased risk of dementia compared to untreated patients the risk of dementia. • What is the meaning of the finding? These findings suggest that timely accessing antiviral therapy in chronic hepatitis C-infected patients is important to reduce dementia burden. Eradication of hepatitis C virus (HCV) infection has been linked with improvement in neurocognitive function, but few studies have evaluated the effect of antiviral treatment/ response on risk of dementia. Using data from the Chronic Hepatitis Cohort Study (CHeCS), we investigated how antiviral therapy impacts the risk of developing dementia among patients with HCV. A total of 17,485 HCV patients were followed until incidence of dementia, death, or last follow-up. We used an extended landmark modeling approach, which included time-varying covariates and propensity score justification for treatment selection bias, as well as generalized estimating equations (GEE) with a link function as multinominal distribution for a discrete time-to-event data. Death was considered a competing risk. After 15 years of follow-up, 342 patients were diagnosed with incident dementia. Patients who achieved sustained virological response (SVR) had significantly decreased risk of dementia compared to untreated patients, with hazard ratios (HRs) of 0.32 (95% CI 0.22–0.46) among patients who received direct-acting antiviral (DAA) treatment and 0.41 (95% CI 0.26–0.60) for interferon-based (IFN) treatment. Risk reduction remained even when patients failed antiviral treatment (HR 0.38, 95% CI 0.38–0.51). Patients with cirrhosis, Black/African American patients, and those without private insurance were at significantly higher risk of dementia. Antiviral treatment independently reduced the risk of dementia among HCV patients, regardless of cirrhosis. Our findings support the importance of initiation antiviral therapy in chronic HCV-infected patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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