OBJECTIVES: A recent meta-analysis found that individuals infected with hepatitis C virus (HCV) had increased risks of cardiovascular disease (CVD) and CVD-related mortalityThis study aimed to examine whether antiviral therapy for HCV infection was associated with improved CVD outcomes. METHODS: A retrospective cohort study was conducted using administrative claims from Truven Health MarketScan Commercial Claims Database (2008-2013). Patients >=18 years old with newly diagnosed HCV by ICD-9-CM codes, who initiated interferon-based therapy (treated cohort) and matched untreated controls (untreated cohort), had no prior history of CVD at least 12 months were included. Patient who had >= 1 prescription of IBT will be counted as treated person. The index date was defined as the first date of prescription claim for interferon. Patients were followed up for the occurrence of the first CVD including Coronary Heart Disease (CHD), Cerebrovascular Disease (CCV), Peripheral Arterial Disease (PAD), and Congestive Heart Failure (CHF). Cox proportional hazard models with propensity score matching (1:1) were employed. RESULTS: In the propensity score-matched cohorts, a total of 11,232 HCV patients were identified to meet the inclusion criteria (treated cohort: n=5616, mean age= 52yrs, 61.20% male; untreated cohort: n=5616, mean age= 51yrs, 58.56% male). During 8,695.6 person-years of treated cohort follow-up, 302 CVD cases happened (crude incidence: 34.73/1000 person-yrs), while 365 events occurred during the 8,557.6 person-years of follow up time in untreated cohort (crude incidence: 42.65/1000 person-yrs). After multivariate adjustment, antiviral therapy was associated with the decreased risk of CVD compared to untreated cohort, although this was not statistically significant (HR=0.931 95%CI 0.797-1.088). CONCLUSIONS: Our findings suggest that antiviral treatment for HCV infection was associated with reduced CVD risk in HCV patients, although this was not statistically significant. Further study are needed to examine the effects of adherence to antiviral therapy on CVD outcomes.