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The possible role of hepatitis A virus in the pathogenesis of atherosclerosis
J Zhu1, A A Quyyumi, J E Norman
1Cardiovascular Research Institute, MedStar Research Institute, Washington Hospital Center, Washington, DC 20010, USA.
Insights
Hepatitis A virus (HAV) infection is linked to coronary artery disease (CAD). HAV-seropositive patients showed higher CAD prevalence and C-reactive protein (CRP) levels, suggesting HAV may contribute to atherosclerosis.
Area of Science:
- Infectious Diseases
- Cardiovascular Medicine
- Immunology
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- The role of infectious agents, including hepatitis A virus (HAV), in the pathogenesis of atherosclerosis is under investigation.
- Inflammation, indicated by C-reactive protein (CRP), is a key factor in CAD development.
Purpose of the Study:
- To investigate the association between hepatitis A virus (HAV) infection and the prevalence of coronary artery disease (CAD).
- To determine if HAV seropositivity is an independent risk factor for CAD.
- To examine the relationship between HAV infection and C-reactive protein (CRP) levels in patients undergoing coronary angiography.
Main Methods:
- Serum IgG antibodies to HAV and CRP levels were measured in 391 patients undergoing coronary angiography.
- Prevalence of CAD was compared between HAV-seropositive and HAV-seronegative individuals.
- Logistic regression analysis was used to assess HAV seropositivity as an independent predictor of CAD and elevated CRP, adjusting for traditional risk factors and other infectious agents.
Main Results:
- 52% of patients were positive for anti-HAV IgG antibodies.
- CAD prevalence was significantly higher in HAV-seropositive patients (74%) compared to HAV-seronegative patients (52%) (P<.0001).
- CRP levels were significantly higher in HAV-seropositive patients (P=.013), and HAV seropositivity independently predicted both CAD and elevated CRP.
Conclusions:
- Hepatitis A virus (HAV) infection is significantly associated with coronary artery disease (CAD).
- HAV seropositivity is an independent predictor of CAD risk and elevated C-reactive protein (CRP) levels.
- These findings suggest a potential causal role for HAV in the development of atherosclerosis.
Abstract:
The possible association between hepatitis A virus (HAV) infection and coronary artery disease (CAD) was studied. Blood from 391 patients undergoing coronary angiography was tested for serum IgG antibodies to HAV and C-reactive protein (CRP). Of the 391 patients, 205 (52%) had anti-HAV IgG antibodies. CAD prevalence was 74% in HAV-seropositive and 52% in HAV-seronegative patients (P<.0001); significance persisted after adjustment for either traditional CAD risk factors or for risk factors plus other infectious agents (cytomegalovirus, Chlamydia pneumoniae, Helicobacter pylori, and herpes simplex virus). In addition, CRP levels were significantly higher in HAV-seropositive than in HAV-seronegative patients (P=. 013) in both univariate and multivariate analyses. Logistic regression analysis demonstrated that HAV seropositivity is an independent predictor of risk for CAD and elevated CRP levels. HAV infection is therefore associated with CAD, which raises the possibility that this virus may play a causal role in atherogenesis.
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