Chronic HCV infection is a risk of atherosclerosis. Role of HCV and HCV-related steatosis.

Abstract

OBJECTIVES:

HCV and NAFLD are associated with atherosclerosis in general population. The prevalence of atherosclerosis in chronic hepatitis C (CHC) patients is unknown. We hypothesized that HCV per se and HCV-related steatosis could favour atherosclerosis. Thus, in CHC patients we assessed: (a) the prevalence of atherosclerosis; (b) the role of HCV, cardio-metabolic risk factors and hepatic histology.

METHODS:

Overall, 803 subjects were enrolled: (A) 326 patients with liver biopsy-proven treatment naive CHC (175 with and 151 without steatosis); (B) 477 age and gender matched controls, including 292 healthy subjects without steatosis (B1) and 185 with NAFLD (B2). Carotid atherosclerosis (CA), assessed by high-resolution B-mode ultrasonography, was categorized as either intima-media thickness (IMT: >1mm) or plaques (≥ 1.5mm).

RESULTS:

CHC patients had a higher prevalence of CA than controls (53.7% vs 34.3%; p<0.0001). Younger CHC (<50 years) had a higher prevalence of CA than controls (34.0% vs 16.0%; p<0.04). CHC patients without steatosis had a higher prevalence of CA than B1 controls (26.0% vs 14.8%; p<0.02). CHC with steatosis had a higher prevalence of CA than NAFLD patients (77.7% vs 57.8%, p<0.0001). Viral load was associated with serum CRP and fibrinogen levels; steatosis with metabolic syndrome, HOMA-IR, hyperhomocysteinemia and liver fibrosis. Viral load and steatosis were independently associated with CA. Diabetes and metabolic syndrome were associated with plaques.

CONCLUSION:

HCV infection is a risk factor for earlier and facilitated occurrence of CA via viral load and steatosis which modulate atherogenic factors such as inflammation and dysmetabolic milieu.

• Authors: Luigi E Adinolfi, Luciano Restivo, Rosa Zampino, Barbara Guerrera, Amedeo Lonardo, Laura Ruggiero, Francesco Riello, Paola Loria, Anna Florio
• Journal: Atherosclerosis (Atherosclerosis) Vol. 221 Issue 2 Pg. 496-502 (Apr 2012) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 22385985 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012. Published by Elsevier Ireland Ltd.

Topics

• Adult
• Age Factors
• Aged
• Biopsy
• Carotid Artery Diseases (diagnostic imaging, epidemiology)
• Carotid Intima-Media Thickness
• Case-Control Studies
• Fatty Liver (diagnosis, epidemiology)
• Female
• Hepatitis C, Chronic (diagnosis, epidemiology)
• Humans
• Italy (epidemiology)
• Logistic Models
• Male
• Metabolic Syndrome (epidemiology)
• Middle Aged
• Multivariate Analysis
• Non-alcoholic Fatty Liver Disease
• Plaque, Atherosclerotic (diagnostic imaging, epidemiology)
• Prevalence
• Prospective Studies
• Risk Assessment
• Risk Factors
• Viral Load
• Young Adult