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Hepatitis C Virus Infection and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis
Karn Wijarnpreecha1, Charat Thongprayoon1, Panadeekarn Panjawatanan2
1Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
Insights
Hepatitis C virus (HCV) infection is linked to a higher risk of venous thromboembolism (VTE). This meta-analysis confirms an increased VTE risk in HCV patients, highlighting the need for clinical consideration.
Area of Science:
- Hepatology
- Thrombosis Research
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection is a major cause of cirrhosis.
- Chronic inflammation from HCV may elevate the risk of venous thromboembolism (VTE).
- Existing data on the association between HCV and VTE is inconclusive.
Purpose of the Study:
- To systematically review and synthesize evidence on the association between HCV infection and VTE risk.
- To quantify the risk of VTE in patients with HCV infection compared to those without.
Main Methods:
- A comprehensive literature search was conducted in MEDLINE and EMBASE up to April 2016.
- Included studies reported risk ratios, odds ratios, or hazard ratios for VTE in HCV-infected individuals.
- A random-effect meta-analysis was performed to calculate pooled risk ratios (RR) and 95% confidence intervals (CI).
Main Results:
- Three studies were included in the meta-analysis.
- HCV-infected patients showed a significantly increased pooled RR of VTE (1.38; 95% CI, 1.08-1.77).
- Subgroup analyses suggested increased risks for pulmonary embolism (PE) and deep venous thrombosis (DVT), though not statistically significant.
Conclusions:
- HCV infection is associated with a significantly elevated risk of VTE.
- Further research is needed to guide clinical management of VTE risk in HCV patients.
Background/Objectives:
Hepatitis C virus (HCV) infection is one of the leading causes of cirrhosis. As a result of chronic inflammatory response to the virus, HCV-infected patients may be at a higher risk of venous thromboembolism (VTE). However, the data on this association is unclear. This systematic review and meta-analysis was conducted with the aims to summarize all available evidence.
Material And Methods:
A literature search was performed using MEDLINE and EMBASE from inception to April 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of VTE among HCV-infected patients vs. subjects without HCV infection were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.
Results:
Three studies met our eligibility criteria and were included in analysis. The pooled RR of VTE in HCV-infected patients vs. subjects without HCV infection was 1.38 (95% CI, 1.08-1.77, I2 = 40%). Subgroup analysis showed that risk was increased for both pulmonary embolism (PE) and deep venous thrombosis (DVT) even though without adequate power to demonstrate statistical significance (Pooled RR of 1.34, 95% CI, 0.67-2.66 for PE and pooled RR 1.45, 95% CI, 0.93-2.77 for DVT).
Conclusion:
Our study demonstrated a significantly increased risk of VTE among HCV-infected patients. Further studies are required to clarify how this risk should be addressed in clinical practice.
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