| Institution: | 1. Department of Gastroenterology and Hepatology, Henry Ford Health, Detroit, Michigan, United States;2. Department of Gastroenterology and Hepatology, Henry Ford Health, Detroit, Michigan, United States
School of Medicine, Wayne State University, Detroit, Michigan, United States;3. Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, United States;4. Center on Aging & Health, Johns Hopkins University, Baltimore, Maryland, United States;5. Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, Hawaii, United States;6. Biomedical Consulting Group LLC, Mahway, New Jersey, United States;7. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, United States;8. Department of Health Policy and Health Systems Research, Henry Ford Health, Detroit, Michigan, United States |
| Abstract: | Research suggests a possible link between chronic infection with hepatitis C virus (HCV) and the development of Parkinson's Disease (PD) and secondary Parkinsonism (PKM). We investigated the impact of antiviral treatment status (untreated, interferon IFN] treated, direct-acting antiviral DAA] treated) and outcome (treatment failure TF] or sustained virological response SVR]) on risk of PD/PKM among patients with HCV. Using data from the Chronic Hepatitis Cohort Study (CHeCS), we applied a discrete time-to-event approach with PD/PKM as the outcome. We performed univariate followed by a multivariable modelling that used time-varying covariates, propensity scores to adjust for potential treatment selection bias and death as a competing risk. Among 17,199 confirmed HCV patients, we observed 54 incident cases of PD/PKM during a mean follow-up period of 17 years; 3753 patients died during follow-up. There was no significant association between treatment status/outcome and risk of PD/PKM. Type 2 diabetes tripled risk (hazard ratio HR] 3.05; 95% CI 1.75–5.32; p < .0001) and presence of cirrhosis doubled risk of PD/PKM (HR 2.13, 95% CI 1.31–3.47). BMI >30 was associated with roughly 50% lower risk of PD/PKM than BMI <25 (HR 0.43; 0.22–0.84; p = .0138). After adjustment for treatment selection bias, we did not observe a significant association between HCV patients' antiviral treatment status/outcome on risk of PD/PKM. Several clinical risk factors—diabetes, cirrhosis and BMI—were associated with PD/PKM. |
