{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T23:01:35Z","timestamp":1779922895106,"version":"3.53.1"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["RP150587"],"award-info":[{"award-number":["RP150587"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","award":["CIN 13-413"],"award-info":[{"award-number":["CIN 13-413"]}],"id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 DK56338"],"award-info":[{"award-number":["P30 DK56338"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Direct\u2010acting anti\u2010viral (DAA) therapy may have a beneficial role in extrahepatic manifestations of hepatitis C virus (HCV) infection. However, the available data are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the effects of DAA treatment on the risk of several extrahepatic manifestations of HCV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of patients from the US Department of Veterans Affairs Corporate Data Warehouse who had a positive HCV RNA test and received first course of DAAs between 2012 and 2016. We calculated incidence rates by sustained virological response (SVR) status for six extrahepatic manifestations, and effect of SVR on these conditions was evaluated in adjusted Cox regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 45\u00a0260 patients treated with DAA with mean follow\u2010up of 2.01\u00a0years, 41\u00a0711 (92.2%) experienced SVR. Incidence rates ranged from 0.17\/1000 PY for porphyria cutanea tarda to 21.04\/1000 PY for diabetes in the SVR group and 0.51\/1000 PY for porphyria cutanea tarda to 23.11\/1000 PY for diabetes in the no SVR group. The risk was reduced with SVR for mixed cryoglobulinaemia (adjusted HR (aHR)\u00a0=\u00a00.23; 95% CI 0.10\u20100.56), glomerulonephritis (aHR\u00a0=\u00a00.61; 95% CI 0.41\u20100.90) and lichen planus (aHR\u00a0=\u00a00.46; 95% CI 0.30\u20100.70), but not for non\u2010Hodgkin's lymphoma (aHR\u00a0=\u00a00.86; 95% CI 0.52\u20101.43) or diabetes (aHR\u00a0=\u00a00.98; 95% CI 0.81\u20101.19). Non significant risk reduction was seen for porphyria cutanea tarda (aHR\u00a0=\u00a00.33; 95% CI 0.11\u20101.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Successful DAA treatment resulting in SVR was associated with significant reductions in the risk of mixed cryoglobulinaemia, glomerulonephritis, lichen planus and possibly porphyria cutanea tarda, but not non\u2010Hodgkin's lymphoma or diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15240","type":"journal-article","created":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T09:25:08Z","timestamp":1554110708000},"page":"1442-1447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["The effects of sustained virological response to direct\u2010acting anti\u2010viral therapy on the risk of extrahepatic manifestations of hepatitis C infection"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5964-7579","authenticated-orcid":false,"given":"Hashem B.","family":"El\u2010Serag","sequence":"first","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center Houston Texas"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel C.","family":"Christie","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center Houston Texas"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Puenpatom","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., Inc. Kenilworth New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Castillo","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasiha","family":"Kanwal","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center Houston Texas"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2953-4949","authenticated-orcid":false,"given":"Jennifer R.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center Houston Texas"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15131"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14382"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15101"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-313983"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-316234"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14845"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15102"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.039"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27366"},{"key":"e_1_2_7_11_1","volume-title":"R: a language and environment for statistical computing","author":"R Development Core Team","year":"2018"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208339"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28753"},{"key":"e_1_2_7_14_1","first-page":"S107","article-title":"Long\u2010term effects of the new direct antiviral agents (DAAs) therapy for HCV\u2010related mixed cryoglobulinaemia without renal involvement: a multicentre open\u2010label study","volume":"36","author":"Mazzaro C","year":"2018","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.05.021"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.02.037"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx222"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2017.03.007"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.08.006"},{"key":"e_1_2_7_20_1","first-page":"dc170485","article-title":"Improvement in glycemic control of type 2 diabetes after successful treatment of hepatitis C virus","author":"Hum J","year":"2017","journal-title":"Diabetes Care"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24954"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix517"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000484237"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.18.2010"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-05-714667"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.09.031"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12897"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29364"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12937"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.05.049"}],"container-title":["Alimentary Pharmacology &amp; 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