Background/Aims Steatotic liver disease (SLD) is a common manifestation in chronic hepatitis C (CHC). Metabolic alterations in CHC are associated with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to elucidate whether hepatitis C virus (HCV) eradication mitigates MASLD occurrence or resolution.
Methods We enrolled 5,840 CHC patients whose HCV was eradicated by direct-acting antivirals in a nationwide HCV registry. MASLD and the associated cardiometabolic risk factors (CMRFs) were evaluated at baseline and 6 months after HCV cure.
Result s: There were 2,147 (36.8%) patients with SLD, and 1,986 (34.0%) of them met the MASLD criteria before treatment. After treatment, HbA1c (6.0% vs. 5.9%, P<0.001) and BMI (24.8 kg/m2 vs. 24.7 kg/m2, P<0.001) decreased, whereas HDL-C (49.1 mg/dL vs. 51.9 mg/dL, P<0.001) and triglycerides (102.8 mg/dL vs. 111.9 mg/dL, P<0.001) increased significantly. The proportion of patients with SLD was 37.5% after HCV eradication, which did not change significantly compared with the pretreatment status. The percentage of the patients who had post-treatment MASLD was 34.8%, which did not differ significantly from the pretreatment status (P=0.17). Body mass index (BMI) (odds ratio [OR] 0.89; 95% confidence intervals [CI] 0.85–0.92; P<0.001) was the only factor associated with MASLD resolution. In contrast, unfavorable CMRFs, including BMI (OR 1.10; 95% CI 1.06–1.14; P<0.001) and HbA1c (OR 1.19; 95% CI 1.04–1.35; P=0.01), were independently associated with MASLD development after HCV cure.
Conclusions HCV eradication mitigates MASLD in CHC patients. CMRF surveillance is mandatory for CHC patients with metabolic alterations, which are altered after HCV eradication and predict the evolution of MASLD.
Citations
Citations to this article as recorded by
Editorial: Beyond Viral Eradication—Cardiometabolic Risk and Cardiovascular Outcomes After SVR in Chronic Hepatitis C. Authors' Reply Pei‐Chien Tsai, Jee‐Fu Huang, Ming‐Lung Yu Alimentary Pharmacology & Therapeutics.2026;[Epub] CrossRef
Real‐world efficacy and safety of universal 8‐week glecaprevir/pibrentasvir in patients with chronic hepatitis C with early chronic kidney disease or pre‐end‐stage renal disease: Insights from a nationwide hepatisis C virus registry in Taiwan Szu‐Jen Wang, Chung‐Feng Huang, Te‐Sheng Chang, Ching‐Chu Lo, Chao‐Hung Hung, Chien‐Wei Huang, Lee‐Won Chong, Pin‐Nan Cheng, Ming‐Lun Yeh, Cheng‐Yuan Peng, Chien‐Yu Cheng, Jee‐Fu Huang, Ming‐Jong Bair, Chih‐Lang Lin, Chi‐Chieh Yang, Hsing‐Tao Kuo, Tsai‐Yu The Kaohsiung Journal of Medical Sciences.2025;[Epub] CrossRef
Reply to comment on “Posttreatment FIB-4 score change predicts hepatocellular carcinoma in chronic hepatitis C patients: Findings from the Taiwan hepatitis C registry program” Hung-Wei Wang, Cheng-Yuan Peng, Ming-Lung Yu Journal of the Formosan Medical Association.2025;[Epub] CrossRef
Metabolic dysfunction-associated steatotic liver disease and its associated health risks Xia-Rong Liu, Szu-Ching Yin, Yi-Ting Chen, Mei-Hsuan Lee Journal of the Chinese Medical Association.2025; 88(5): 343. CrossRef
Bridging the Gap in Elimination of Hepatitis C Virus among People Who Use Drugs in South Korea Beom Kyung Kim Gut and Liver.2025; 19(5): 635. CrossRef
Long-term effects of HCV eradication on lipid profiles associated with MASLD among people with HIV with advanced fibrosis or cirrhosis Ana Virseda-Berdices, Belen Requena, Juan Berenguer, Juan Gónzalez-García, Carolina Gonzalez-Riano, Cristina Díez, Victor Hontañón, Paula Muñoz-García, Amanda Fernández-Rodríguez, Coral Barbas, Salvador Resino, Rubén Martín-Escolano, María Ángeles Jiménez Journal of Infection and Public Health.2025; 18(12): 102981. CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease After Hepatitis C Virus Cure Chung‐Feng Huang, Jee‐Fu Huang, Ming‐Lung Yu, Wan‐Long Chuang The Kaohsiung Journal of Medical Sciences.2025;[Epub] CrossRef
Advanced Fibrosis and Cardiometabolic Risk Burden Increase Major Cardiovascular Events in Chronic Hepatitis C Patients With Steatotic Liver Disease After Viral Eradication Pei‐Chien Tsai, Chung‐Feng Huang, Ming‐Lun Yeh, Yu‐Ju Wei, Chih‐Wen Wang, Tyng‐Yuan Jang, Po‐Cheng Liang, Yi‐Hung Lin, Chia‐Yen Dai, Jee‐Fu Huang, Wan‐Long Chuang, Ming‐Lung Yu Alimentary Pharmacology & Therapeutics.2025;[Epub] CrossRef
Steatotic liver disease in patients with chronic hepatitis C Jakub Janczura, Michał Brzdęk, Robert Flisiak, Krystyna Dobrowolska, Kinga Brzdęk, Piotr Rzymski, Dorota Zarębska-Michaluk World Journal of Hepatology.2025;[Epub] CrossRef
Background/Aims Direct‐acting antivirals (DAAs) have been approved for hepatitis C virus (HCV) treatment in patients with end-stage renal disease (ESRD) on hemodialysis. Nevertheless, the complicated comedications and their potential drug-drug interactions (DDIs) with DAAs might limit clinical practice in this special population.
Methods The number, class, and characteristics of comedications and their potential DDIs with five DAA regimens were analyzed among HCV-viremic patients from 23 hemodialysis centers in Taiwan.
Result s: Of 2,015 hemodialysis patients screened in 2019, 169 patients seropositive for HCV RNA were enrolled (mean age, 65.6 years; median duration of hemodialysis, 5.8 years). All patients received at least one comedication (median number, 6; mean class number, 3.4). The most common comedication classes were ESRD-associated medications (94.1%), cardiovascular drugs (69.8%) and antidiabetic drugs (43.2%). ESRD-associated medications were excluded from DDI analysis. Sofosbuvir/velpatasvir/voxilaprevir had the highest frequency of potential contraindicated DDIs (red, 5.6%), followed by glecaprevir/pibrentasvir (4.0%), sofosbuvir/ledipasvir (1.3%), sofosbuvir/velpatasvir (1.3%), and elbasvir/grazoprevir (0.3%). For potentially significant DDIs (orange, requiring close monitoring or dose adjustments), sofosbuvir/velpatasvir/voxilaprevir had the highest frequency (19.9%), followed by sofosbuvir/ledipasvir (18.2%), glecaprevir/pibrentasvir (12.6%), sofosbuvir/velpatasvir (12.6%), and elbasvir/grazoprevir (7.3%). Overall, lipid-lowering agents were the most common comedication class with red-category DDIs to all DAA regimens (n=62), followed by cardiovascular agents (n=15), and central nervous system agents (n=10).
Conclusions HCV-viremic patients on hemodialysis had a very high prevalence of comedications with a broad spectrum, which had varied DDIs with currently available DAA regimens. Elbasvir/grazoprevir had the fewest potential DDIs, and sofosbuvir/velpatasvir/voxilaprevir had the most potential DDIs.
Citations
Citations to this article as recorded by
Predictive value of osteoprotegerin and heart fatty acid binding protein as biomarkers for heart failure in chronic kidney disease patients on hemodialysis: A case-control study Saddam Jaber Khudiar, Rayah Sulaiman Baban, Arif Sami Malik Journal of Research in Pharmacy.2025; 29(2): 682. CrossRef
Direct-acting antiviral therapy for patients with hepatitis C virus-related hepatocellular carcinoma: A nationwide cohort study Shou-Wu Lee, Sheng-Shun Yang, Pei-Chien Tsai, Chung-Feng Huang, Chi-Yi Chen, Chao-Hung Hung, Chien-Hung Chen, Chi-Ming Tai, Pin-Nan Cheng, Hsing-Tao Kuo, Kuo-Chih Tseng, Lein-Ray Mo, Ching-Chu Lo, Yi-Hsiang Huang, Han-Chieh Lin, Pei-Lun Lee, Ming-Jong Bai Clinical and Molecular Hepatology.2025; 31(3): 899. CrossRef
Nationwide hepatitis C virus microelimination in uremic patients undergoing maintenance hemodialysis in Taiwan Chung-Feng Huang, Po-Cheng Liang, Yu-Ju Wei, Chao-Chun Wu, Shi-Lun Wei, Li-Ju Lin, Pei-Chun Hsieh, Tsui-Hsia Hsu, Maggie Shu-Mei Hsu, Ya-Xin Luo, Hsi-Chieh Chen, Tsu-Yun Ho, Shao-Hsuan Lin, Chia-Ling Liu, Kuo-Pen Cheng, John W. Ward, Ming-Lung Yu Journal of the Formosan Medical Association.2025; 124: S102. CrossRef
Cutting-edge pharmacotherapy for hepatitis C virus infection: a comprehensive review Chen-Hua Liu, Yu-Ping Chang, Jia-Horng Kao Expert Opinion on Pharmacotherapy.2024; 25(12): 1691. CrossRef
Comorbidities and Contraindicated Medications in Patients with Chronic Hepatitis C Infection in Japan: a Real-World Database Study Takeya Tsutsumi, Hiroshi Yotsuyanagi Kanzo.2024; 65(8): 368. CrossRef
Enhancing hepatitis C management in ESRD: Evaluating efficacy and safety of alternative antiviral regimens Ume Aiman, Umer Bin Shahzad Therapeutic Apheresis and Dialysis.2024; 28(6): 967. CrossRef
TASL, TADE, and DAROC consensus for the screening and management of hepatitis C in patients with diabetes Ming-Lung Yu, Chih-Yuan Wang, Mei-Hsuan Lee, Horng-Yih Ou, Pin-Nan Cheng, Shih-Te Tu, Jee-Fu Huang, Jung-Fu Chen, Tsung-Hui Hu, Chih-Cheng Hsu, Jia-Horng Kao, Chien-Jen Chen, Han-Chieh Lin, Chien-Ning Huang Journal of the Formosan Medical Association.2023; 122(3): 202. CrossRef
Drug–Drug Interactions With Over-The-Counter Medicines: Mind the Unprescribed Oliver Scherf-Clavel Therapeutic Drug Monitoring.2022; 44(2): 253. CrossRef
Pan-genotypic direct-acting antivirals for patients with hepatitis C virus infection and chronic kidney disease stage 4 or 5 Chen-Hua Liu, Jia-Horng Kao Hepatology International.2022; 16(5): 1001. CrossRef
Drug-drug interactions between antithrombotics and direct-acting antivirals in hepatitis C virus (HCV) patients: A brief, updated report Mario Enrico Canonico, Giuseppe Damiano Sanna, Roberta Siciliano, Fernando Scudiero, Giovanni Esposito, Guido Parodi Frontiers in Pharmacology.2022;[Epub] CrossRef
Evaluation of US Food and Drug Administration Drug Label Recommendations for Coadministration of Antivirals and Acid‐Reducing Agents Tyler Shugg, Nicholas R. Powell, Patrick J. Marroum, Todd C. Skaar, Islam R. Younis Clinical Pharmacology & Therapeutics.2022; 112(5): 1088. CrossRef
Drug–drug interactions between direct-acting antivirals and co-medications: a territory-wide cohort study Vicki Wing-Ki Hui, Christopher Langjun Au, Amy Shuk Man Lam, Terry Cheuk-Fung Yip, Yee-Kit Tse, Jimmy Che-To Lai, Henry Lik-Yuen Chan, Vincent Wai-Sun Wong, Grace Lai-Hung Wong Hepatology International.2022; 16(6): 1318. CrossRef
Real-world experience of serial serum levels of GS-331007 in chronic hepatitis C hemodialysis patients during and after sofosbuvir/velpatasvir therapy Chung-Feng Huang, Yu-Ju Wei, Yu-Tse Wu, Yi-Wen Chiu, Ming-Lung Yu Journal of Hepatology.2021; 75(4): 1006. CrossRef
First
Prev
