Interferon-based therapy reduces risk of stroke in chronic hepatitis C patients: a population-based cohort study in Taiwan

BackgroundHepatitis C virus (HCV) infection has been linked to an increased risk of insulin resistance and carotid atherosclerosis. AimTo investigate the association between HCV infection and stroke, and the effect of interferon-based therapy (IBT) on stroke risk in chronic hepatitis C (CHC) patients. MethodsWe conducted a retrospective cohort study that followed up 3113 subjects with a newly detected HCV infection and 12452 age- and gender-matched subjects without HCV infection selected from a random sample of 10(6) beneficiaries from the Taiwan National Health Insurance Program up to 5years. Use of IBT was defined as treatment with interferon alpha, pegylated interferon alpha-2a or pegylated interferon alpha-2b for at least 3months. The hazard ratio (HR) for newly detected stroke was calculated for subjects with HCV compared to those without HCV, and for IBT-treated HCV patients compared to non-IBT-treated HCV patients while adjusting for possible confounding factors. ResultsThe overall person-years of follow-up were 8624.11 in patients with HCV, 54533.69 in patients without HCV, 666.65 in IBT-treated patients, and 7886.49 in nontreated patients. The multivariable-adjusted hazard ratio (HR) for newly detected stroke was 1.23 for subjects with HCV compared to the age- and sex-matched subjects without HCV (adjusted HR=1.23, 95% CI=1.06-1.42, P=0.008). Moreover, use of IBT significantly reduced the risk of stroke in HCV patients (adjusted HR=0.39, 95% CI=0.16-0.95, P=0.039) after adjusting for known prognostic factors. ConclusionsInterferon-based therapy may reduce the long-term risk of stroke in patients with chronic HCV infection.