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The Inflammatory Relationship Between Hepatitis C Virus With Coronary and Carotid Atherosclerosis
Michael Broker1, Shalom Z Frager2, Nayan S Patel3
1From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
Insights
Hepatitis C virus (HCV) infection may increase the risk of severe coronary artery disease due to systemic inflammation. While evidence is not conclusive, proactive cardioprotective measures are recommended for HCV patients.
Area of Science:
- Cardiology
- Hepatology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection is a global health issue associated with various hepatic and extrahepatic complications.
- Observational studies present conflicting evidence regarding the link between HCV infection and increased risk of coronary and carotid atherosclerosis.
- A lack of randomized controlled trials has prevented a clear consensus on HCV's role in atherosclerosis.
Purpose of the Study:
- To review and synthesize existing literature on the association between Hepatitis C virus infection and atherosclerosis.
- To discuss evidence supporting and refuting the hypothesis that HCV infection contributes to plaque formation.
- To evaluate the implications of HCV infection on coronary artery disease severity.
Main Methods:
- Systematic literature review of observational studies and relevant research.
- Analysis of articles focusing on inflammatory and lipid processes in plaque formation.
- Evaluation of studies examining the relationship between HCV and coronary/carotid atherosclerosis.
Main Results:
- Conflicting findings exist regarding HCV's direct link to atherosclerosis plaque formation and rupture.
- Systemic inflammation associated with HCV infection is a potential contributor to atherosclerosis.
- HCV-infected individuals may face a higher risk of more severe coronary artery disease.
Conclusions:
- While definitive proof is lacking, a potential increased risk for severe coronary artery disease in HCV patients is suggested.
- Both inflammatory and lipid pathways are crucial in atherosclerosis development and treatment.
- Cardioprotective strategies are advised for HCV-infected individuals, particularly those with existing cardiovascular risk factors.
Abstract:
Hepatitis C virus (HCV), a global health concern, has been linked to various hepatic and extrahepatic deleterious manifestations. Several observational studies have either supported the increased likelihood of coronary and carotid atherosclerosis after infection with HCV or refuted it. To date, there has been no clear consensus to support either train of thought, as randomized, controlled clinical trials have not been completed. In this review, we first discuss articles that support the notion that HCV infection leads to increased plaque formation due to systemic inflammation and then focus on articles that refute this idea. From the literature, we do know that both inflammatory and lipid processes play a role in plaque formation, and thus both components are important in the successful treatment of atherosclerosis. Based on our review of the literature, we do believe that HCV-infected individuals are at an increased risk for more severe coronary artery disease than their healthy counterparts. Although there is no irrefutable evidence that links HCV infection with plaque formation and/or rupture, cardioprotective measures should be taken to reduce poor health outcomes, especially in those individuals who are already at risk of coronary disease.
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