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Hypertension may compromise anti-HCV therapy success

Jairia Dela Cruz
28 May 2019

Among patients chronically infected with hepatitis C virus (HCV), presenting with elevated blood pressure during initiation of antiviral therapy is associated with treatment failure, according to a study presented at the Asian Pacific Society of Cardiology (APSC) Congress 2019.

Furthermore, failure to achieve sustained virologic response (SVR) is correlated with the presence of high viral load, the authors said.

The study included 440 treatment-naïve chronic HCV (CHC) patients, among whom 118 (26.8 percent) had high blood pressure or actively used antihypertensive drugs.

Hypertensive and normotensive patients differed significantly in terms of age (57.5 vs 51.6 years), proportion of men (40.7 percent vs 53.4 percent), body mass index (BMI; 25.9 vs 24.2 kg/m2) and triglyceride levels (107.4 vs 95.3 mg/dl), fibrosis scores (3.8 vs 3.1), comorbidity with hyperlipidaemia (17.8 percent vs 4.7 percent) and diabetes (21.2 percent vs 12.1 percent), and SVR rate (75.4 percent vs 84.5 percent).

Multivariable logistic regression models showed that hypertension in CHC was significantly associated with older age (odds ratio [OR], 1.06, 95 percent CI, 1.03–1.09; p<0.001), high BMI (OR, 1.13, 1.05–1.20; p<0.001) and hyperlipidaemia (OR, 4.48, 2.05–9.80; p<0.001). [APSC 2019, poster 26]

The presence of hypertension at antiviral therapy initiation almost halved the chances of achieving SVR (OR, 0.56, 0.33–0.94; p=0.030). Other significant predictors of treatment failure in CHC were higher HCV RNA log (OR, 0.67, 0.57–0.79; p<0.001), higher total cholesterol levels (OR, 0.99, 0.98–0.99; p=0.030), nongenotype 1 HCV (OR, 0.67, 0.57–0.79; p<0.001) and diabetes (OR, 0.45, 0.24–0.82; p=0.009).

Of note, higher HCV RNA log was confirmed to be associated with reduced odds of SVR among hypertensive CHC patients (OR, 0.71, 0.53–0.95; p=0.025).

“It is reported that patients with CHC are more likely to have high blood pressure and other diseases related to glucose and lipid metabolism. High blood pressure is considered as an extrahepatic manifestation of CHC,” the authors noted.

The present data indicate that hypertension may compromise the success of antiviral therapy in CHC patients, especially among those with high viral load, they added.

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Most Read Articles
12 Aug 2019
Treatment with nebivolol yields more favourable changes in 24-hour, intradialytic and daytime systolic and diastolic blood pressure variability in patients with intradialytic hypertension, a study has found.
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
25 Jul 2019
Adding a third drug to achieve the target blood pressure (BP) seems to be more effective than increasing the dose of existing dual therapy without any increase in adverse events, suggest the results of a meta-analysis, adding that early use of triple therapy can help improve hypertension control.