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Published on: February 4, 2021
Hepatitis C virus infection associated with coronary and thoracic aortic atherosclerosis
Chih-Wen Wang1, Chung-Feng Huang2, Ming-Lun Yeh2
1Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital; School of Medicine and Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
Hepatitis C virus (HCV) infection, especially with metabolic syndrome or liver fibrosis, significantly increases the risk of developing coronary and thoracic aortic atherosclerosis. Early detection and management are crucial for preventing cardiovascular complications in HCV patients.
Area of Science:
- Cardiovascular Medicine
- Hepatology
- Infectious Diseases
Background:
- Coronary and thoracic aortic calcification are linked to major vascular diseases like stroke.
- Hepatitis C virus (HCV) infection is a known risk factor for metabolic abnormalities, including insulin resistance and diabetes.
- The association between HCV infection and atherosclerosis requires further investigation.
Purpose of the Study:
- To explore the relationship between Hepatitis C virus infection and the presence of coronary and thoracic aortic atherosclerosis.
- To assess how metabolic syndrome and liver fibrosis indicators modify this association.
Main Methods:
- Calcification was quantified using chest computed tomography (Agatston score).
- Metabolic syndrome was diagnosed using modified Adult Treatment Panel III criteria.
- HCV infection status, liver fibrosis (FIB-4, APRI), and viral load (anti-HCV S/CO ratio) were assessed.
Main Results:
- HCV infection was independently associated with atherosclerosis (OR=2.75).
- The combination of HCV and metabolic syndrome showed a significant association with atherosclerosis (OR=2.65).
- HCV with liver fibrosis (FIB-4 or APRI) or elevated anti-HCV S/CO ratio also demonstrated increased atherosclerosis risk.
Conclusions:
- HCV infection is a significant risk factor for coronary and thoracic aortic atherosclerosis.
- Metabolic syndrome and indicators of liver fibrosis exacerbate this risk.
- Elevated anti-HCV S/CO ratio is also linked to atherosclerosis in HCV patients.
Background:
Coronary and thoracic aortic calcification was associated with stroke, coronary heart, and peripheral vascular disease. Hepatitis C virus (HCV) infection is significantly associated with insulin resistance, diabetes mellitus and hepatic steatosis. We aimed to investigate the relationship between HCV infection and coronary, thoracic aortic atherosclerosis.
Materials And Methods:
Calcification was detected by chest computed tomography and defined as any Agatston score greater than zero. Metabolic syndrome was based on the modified Adult Treatment Panel III criteria. Fibrosis-4 (FIB-4) and AST-to-platelet ratio (APRI) was calculated. The anti-HCV signal-to-cutoff (S/CO) ratio was determined by the third generation ELISA kit. Atherosclerosis risk was estimated by using multiple logistic regression modeling.
Results:
Being positive for both metabolic syndrome and HCV infection (OR = 2.65, 95% CI: 1.26-5.59, p = 0.007), negative for metabolic syndrome and positive for HCV infection (OR = 2.75, 95% CI: 1.48-5.30, p = 0.001), and positive for metabolic syndrome and negative for HCV infection (OR = 2.42, 95% CI: 1.92-3.07, p < 0.001) were associated with atherosclerosis compared with being negative for both metabolic syndrome and HCV infection (Ptrend< 0.001). HCV infection with liver fibrosis (HCVFIB4>1.4; OR = 2.16, 95% CI: 1.22-3.82, p = 0.008), or (HCVAPRI>0.5; OR = 3.40, 95% CI: 1.28-9.06, p = 0.014) and elevated anti-HCV S/CO ratio (anti-HCVS/CO>10.0; OR = 1.72, 95% CI: 1.01-2.93, p = 0.045) was associated with atherosclerosis.
Conclusions:
HCV infection with metabolic syndrome, liver fibrosis and elevated anti-HCV S/CO ratio was associated with atherosclerosis.
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