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Inflammatory and cardiovascular diseases biomarkers in chronic hepatitis C virus infection: A review
Ahmed Babiker1, Mohamed Hassan2, Safwan Muhammed3,4
1Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Insights
Hepatitis C virus (HCV) infection elevates cardiac and inflammatory biomarkers, increasing cardiovascular disease (CVD) risk. Standard CVD risk tools may underestimate this risk in HCV patients due to these elevated markers.
Area of Science:
- Hepatology and Virology
- Cardiology and Cardiovascular Diseases
- Immunology and Inflammation
Background:
- Hepatitis C virus (HCV) infection affects 180 million globally, posing a significant risk for chronic liver disease and clinical cardiovascular disease (CVD).
- Elevated cardiac and inflammatory biomarkers are observed in chronic HCV infection (CHC), but their specific role in CVD risk stratification within this population remains unclear.
- Existing CVD risk stratification tools may not adequately address the heightened inflammatory state associated with HCV infection.
Purpose of the Study:
- To systematically review inflammatory and cardiac biomarkers in individuals with HCV infection.
- To assess the impact of CHC on serum levels of these biomarkers before and during HCV therapy.
- To evaluate the utility of these biomarkers in predicting CVD risk specifically within the HCV-infected population.
Main Methods:
- A systematic review of Medline, EMBASE, and Cochrane databases was conducted, searching for relevant articles up to June 2019.
- A comprehensive review of 2430 identified results, with 115 studies ultimately included in the analysis.
- Focus on studies examining inflammatory, endothelial function, and cardiac dysfunction markers in HCV patients.
Main Results:
- HCV infection significantly alters serum levels of inflammation, endothelial function, and cardiac dysfunction markers.
- These alterations occur prior to the initiation of HCV treatment.
- Some biomarker levels may exhibit changes in response to antiviral therapy for HCV.
Conclusions:
- HCV infection is associated with significant changes in biomarkers related to inflammation and cardiac function.
- These changes suggest an elevated intrinsic risk for cardiovascular disease in HCV-infected individuals.
- Current CVD risk stratification models may require adjustment to incorporate the inflammatory burden present in CHC patients.
Abstract:
Hepatitis C virus (HCV) infects 180 million people worldwide and over 4 million people in the United States. HCV infection is a major cause of chronic liver disease and is recognized as a risk factor for clinical cardiovascular disease (CVD). Many studies have shown increased prevalence of cardiac and inflammatory biomarkers in patients with chronic HCV infection (CHC), and though these markers may be used to risk stratify people for cardiac disease in the general population their role in the HCV population is unknown. Patients with CHC have elevated cardiac and inflammatory biomarkers compared to noninfected controls which may play a role in CVD risk stratification. We undertook a systematic review of inflammatory and cardiac biomarkers in people with HCV infection with a focus on the effect of CHC on serum levels of these markers and their utility as predictors of CVD in this population. Medline, EMBASE, and Cochrane databases were searched for relevant articles until June 2019. A total of 2430 results were reviewed with 115 studies included. Our review revealed that HCV infection significantly alters serum levels of markers of inflammation, endothelial function, and cardiac dysfunction prior to HCV treatment, and some of which may change in response to HCV therapy. Current risk stratification tools for development of CVD in the general population may not account for the increased inflammatory markers that appear to be elevated among HCV-infected patients contributing to increased CVD risk.
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