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Multicenter study on hepatitis C virus infection in patients with dilated cardiomyopathy. North Italy Transplant
1Centro Trasfusionale e di Immunologia dei Trapianti, IRCCS Ospedale Maggiore, Milano, Italy. dprati@yahoo.com
Insights
Hepatitis C virus (HCV) infection does not appear to be a primary cause of dilated cardiomyopathy (DCM) in Italian patients. Further large-scale international studies are needed to confirm these findings, which contrast with some previous research.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Preliminary studies suggested a link between Hepatitis C Virus (HCV) infection and the development of dilated cardiomyopathy (DCM).
- A hypothesis proposed HCV as a potential etiological factor in DCM pathogenesis.
Purpose of the Study:
- To investigate the association between HCV infection and DCM in a large cohort of Italian patients with end-stage heart failure.
- To verify the hypothesis that HCV plays a role in the development of DCM.
Main Methods:
- A multicenter study involving 752 consecutive patients awaiting cardiac transplantation.
- Serological testing for anti-HCV antibodies was performed.
- Prevalence of HCV infection was compared between patients with and without DCM.
Main Results:
- Overall, 5.4% of patients tested anti-HCV-reactive.
- HCV infection prevalence was 3.9% in patients with DCM and 6.5% in those without DCM.
- No statistically significant difference in HCV prevalence was observed between the DCM and non-DCM groups.
Conclusions:
- HCV does not appear to be a primary etiological factor in the pathogenesis of DCM in this Italian cohort.
- Findings contradict some previous studies, suggesting the need for larger, international research.
- Further investigation across diverse populations is warranted to fully understand the potential role of HCV in heart conditions.
Abstract:
Preliminary epidemiological and histological studies from Japan suggested that hepatitis C virus (HCV) infection has a role in the development of dilated cardiomyopathy (DCM). This multicenter study was conducted to verify this hypothesis on a large cohort of Italian patients with end-stage heart failure. Antibodies to HCV were determined in the 752 consecutive patients (608 males and 144 females; age, 53 +/- 13 years) who entered the waiting list for cardiac transplantation from 1995 to 1997 at the six cardiac surgery centers participating in the North Italy Transplant program. Three hundred and nine patients (41%) had dilated, 9 (1%) restrictive, and 4 (0.5%) hypertrophic cardiomyopathy; 284 patients (38%) had ischemic, 65 (9%) valvular, and 22 (3%) congenital heart disease; 5 patients (0.5%) had primary pulmonary hypertension; 54 patients (7%) had other or nonspecified heart disease. Overall, 41 of 752 patients (5.4%) resulted anti-HCV-reactive. Serological evidence of HCV infection was found in 12 of 309 patients with DCM (3.9%; 95% CI, 1.7-6.0), and in 29 of 443 without DCM (6.5%; 95% CI, 4.2-8.8), without statistical difference (difference of prevalence rate: 2.6%; 95% CI, -4.9 to 5.8). In conclusion, HCV does not seem to have a primary role in the pathogenesis of DCM. However, since our findings are in disagreement with those obtained in smaller series of patients of other ethnicity, large studies from different countries should be conducted.