Related Experiment Videos
Hepatitis C virus and cardiomyopathy
1Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan. amat@kuhp.kyoto-u.ac.jp
Insights
Hepatitis C virus (HCV) infection is linked to heart conditions like hypertrophic and dilated cardiomyopathy. Detecting HCV RNA in preserved heart tissues and observing treatment responses suggests HCV is a significant cause of unexplained heart disease.
Area of Science:
- Cardiology
- Infectious Diseases
- Virology
Background:
- Hepatitis C virus (HCV) infection is increasingly recognized in patients with hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM).
- Prevalence of HCV antibodies is significantly higher in cardiomyopathy patients compared to blood donors.
- Cardiac abnormalities, particularly arrhythmias, are common in HCV-infected individuals.
Purpose of the Study:
- To investigate the association between Hepatitis C virus infection and idiopathic cardiomyopathies.
- To detect Hepatitis C virus RNA in autopsied heart tissues from patients with various cardiac conditions.
- To evaluate the efficacy of interferon therapy in treating myocardial injury caused by Hepatitis C virus.
Main Methods:
- HCV antibody screening in cardiomyopathy patients and blood donors.
- Detection of HCV RNA using RT-PCR on paraffin-embedded autopsied heart sections.
- Assessment of myocardial injury using TL-201-SPECT and evaluation of interferon treatment response.
Main Results:
- HCV antibody prevalence was significantly higher in HCM (10.6%) and DCM (6.3%) patients than in blood donors (5.4%).
- HCV RNA was detected in 21.3% of examined hearts, including those with HCM, DCM, and myocarditis.
- Interferon therapy improved myocardial injury (SPECT scores) in 53% of patients, and HCV RNA cleared from circulation in most responders.
Conclusions:
- Hepatitis C virus infection is an important cause of unexplained heart diseases, including cardiomyopathies.
- HCV RNA can be detected in long-term preserved cardiac tissues, confirming viral presence in the heart.
- Interferon therapy shows promise in treating HCV-associated myocardial injury.
Abstract:
The importance of hepatitis C virus infection has been recently noted in patients with hypertrophic cardiomyopathy or dilated cardiomyopathy. In a collaborative research project of the Committees for the Study of Idiopathic Cardiomyopathy, hepatitis C virus antibody was found in 74 of 697 patients (10.6%) with hypertrophic cardiomyopathy and in 42 of 663 patients (6.3%) with dilated cardiomyopathy; these prevalences were significantly higher than that found in volunteer blood donors in Japan. Hepatitis C virus antibody was detected in 650 of 11,967 patients (5.4%) seeking care in 5 academic hospitals. Various cardiac abnormalities were found, and arrhythmias were the most frequent. These observations suggest that hepatitis C virus infection is an important cause of a variety of otherwise unexplained heart diseases. As a collaborative research with National Cardiovascular Center and Juntendo University, we tried to detect hepatitis C virus genomes using paraffin sections of autopsied hearts. Among 106 hearts examined, beta-actin gene was amplified in 61 hearts (52.6%). Among these, hepatitis C virus RNA was detected in 13 hearts (21.3%), and negative strands in 4 hearts (6.6%). Hepatitis C virus RNA was found in 6 hearts (26.0%) with hypertrophic cardiomyopathy, 3 hearts (11.5%) with dilated cardiomyopathy, 4 hearts (33.3%) with myocarditis. These hepatitis C virus RNA positive samples were obtained between 1979 and 1990, indicating that hepatitis C virus RNA can be amplified from paraffin-embedded hearts preserved for many years. More recently, we examined the effect of interferon on myocardial injury associated with active hepatitis C. As TL-201-SPECT was a more sensitive method to detect myocardial injury induced by hepatitis C virus than electrocardiography or echocardiography, we used TI-SPECT scores to evaluate the effect of interferon on myocardial injury. SPECT scores improved in 8 patients (53%) out of 15 patients in whom interferon therapy was completed. Circulating hepatitis C virus disappeared after interferon therapy in all 11 patients with improvement or no change, but hepatitis C virus genomes persisted in the blood in 2 aggravated patients. Although this study is preliminary, interferon therapy is a promising treatment for myocardial diseases caused by hepatitis C virus infection.