Sustained virological response to hepatitis C therapy does not decrease the incidence of systemic lupus erythematosus or rheumatoid arthritis

Wei‐Fan Hsu ,Yen Cheng Chiu ,Chi Ming Tai ,Pei Chien Tsai ,Wan-Ting Tsai ,Jing Houng Wang ,Hsing Tao Kuo ,Chao Hung Hung ,Yi Hsiang Huang ,Ching Chu Lo ,Chia Yen Dai ,Han Chieh Lin ,Shui‐Yi Tung ,Gin Ho Lo ,Hsueh Chou Lai ,Sheng Yan ,Chi Yi Chen ,Ming Jong Bair ,Rong Nan Chien ,Ming Yu ,Pin Nan Cheng ,Chih Jen Chen ,Pei Lun Lee ,Chia-Chi Wang,Jin Cheng ,Jia‐Horng Kao ,Chun‐Yen Lin ,Jyh Jou Chen ,Cheng Hsin Chu ,Wan‐Long Chuang ,Cheng-Wei Lin ,Jiun-Chi Huang ,Chen–Hua Liu ,Wei Su ,Ching-Ping Yang ,Kuo‐Chih Tseng ,Cheng Yuan Peng

doi:10.1038/s41598-020-61991-3

Abstract

In patients with chronic hepatitis C (CHC), the effects of baseline characteristics, virological profiles, and therapeutic outcome to pegylated interferon plus ribavirin (PR) therapy on autoimmune diseases are unknown. Taiwanese Chronic Hepatitis C Cohort is a nationwide hepatitis C virus registry cohort comprising 23 hospitals of Taiwan. A total of 12,770 CHC patients receiving PR therapy for at least 4 weeks between January 2003 and December 2015 were enrolled and their data were linked to the Taiwan National Health Insurance Research Database for studying the development of 10 autoimmune diseases. The mean follow-up duration was 5.3 ± 2.9 years with a total of 67,930 person-years, and the annual incidence of systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) was 0.03%. Other autoimmune diseases were not assessable due to few events. Body mass index ≥24 kg/m2 was an independent predictor of the low incidence of SLE or RA (hazard ratio 0.40, 95% confidence interval 0.17–0.93, p = 0.034). A sustained virological response (SVR) to PR therapy was not associated with the low incidence of SLE or RA in any subgroup analysis. CHC patients achieving SVR to PR therapy did not exhibit an impact on the incidence of SLE or RA compared with non-SVR patients.

Highlights

In this multicenter retrospective study, we observed that sustained virological response (SVR) to plus ribavirin (PR) therapy does not decrease the incidence of systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) in Chronic hepatitis C (CHC) patients
Taiwanese Chronic Hepatitis C Cohort (T-COACH) is a nationwide hepatitis C virus (HCV) registry consortium that includes 23 regional hospitals and medical centers of Taiwan from January 2003 to December 2015, and T-COACH accounted for 21% of the treated CHC population of Taiwan over the 13-year period
We found that body mass index (BMI) ≥24 kg/m2 was the only predictor of the low incidence of SLE or RA

Summary

Introduction

A total of 12,770 CHC patients receiving PR therapy for at least 4 weeks between January 2003 and December 2015 were enrolled and their data were linked to the Taiwan National Health Insurance Research Database for studying the development of 10 autoimmune diseases. Direct-acting antiviral agents (DAAs) are the standard of care for CHC6,6, the data of the effect of a sustained virological response (SVR) to PR therapy on the incidence of autoimmune diseases provide valuable information for physicians. We conducted this nationwide cohort study to elucidate the effects of baseline factors and therapeutic outcome of PR therapy on the incidence of autoimmune diseases in CHC patients

Methods

Results

Conclusion