People with genotype 1 hepatitis C should have regular and comprehensive cardiovascular risk assessments, Australian gastroenterologists advise.

Reporting the results of their study in the Internal Medicine Journal Professor Leon Adams from the Sir Charles Gairdner Hospital in Perth and colleagues found no overall differences in arterial stiffness, endothelial dysfunction and carotid intima-media thickness between the 50 patients with chronic hepatitis C involved in the study and 22 matched controls.

However, patients with genotype 1 hepatitis had significantly more severe endothelial dysfunction and carotid intima thickening than those with non-genotype 1 infection.

In a second part of the study the researchers observed a significant improvement in insulin resistance and arterial stiffness in seven patients who had a sustained virological response 18 months after starting anti-viral treatment with pegylated interferon and ribavirin.

This suggested viral eradication may improve cardiovascular risk but further studies were needed to clarify the effect, the researchers said.

Improvements were not seen in other measures of cardiovascular risk, which may reflect an under powering of the study, the research team noted.

“[the finding] may suggest that the vascular risk mediated by hepatitis C is mediated predominantly through vascular stiffness which was reduced with viral eradication, or via endothelial dysfunction in the case of genotype 1 disease,” they wrote.

Nonetheless, the study has implications for the management of patients with chronic hepatitis C, says Professor Adams.

“Treatment with protease triple therapy, which was not available at the time of the study, may increase eradication rates,” he told the limbic.

“In the meantime, we should be informing patients with CHC of their cardiovascular risk and advising them to alter modifiable risk factors.”