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Chronic hepatitis C and the risk for atherosclerotic and cardiomyopathic heart disease

Ismail Elkhattib1, Kareem Wael Raafat2, Basant Elsayed3

  • 1Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68105, United States. ismailkhattib89@gmail.com.

World Journal of Hepatology
|September 3, 2025
PubMed

Insights

Hepatitis C virus (HCV) infection is linked to cardiovascular issues like atherosclerosis and cardiomyopathy. Viral load and steatosis are key risk factors, highlighting the need for further research into HCV and heart disease.

Area of Science:

  • Cardiovascular Medicine
  • Hepatology
  • Virology

Background:

  • Hepatitis C virus (HCV) infection is primarily known for liver disease but is increasingly linked to cardiovascular complications.
  • Carotid atherosclerosis and cardiomyopathy are significant cardiovascular issues associated with chronic HCV infection.

Purpose of the Study:

  • To explore the association between Hepatitis C virus infection and cardiovascular complications.
  • To investigate the mechanisms underlying HCV-related atherosclerosis and cardiomyopathy.
  • To identify risk factors and understand the pathogenesis of cardiovascular disease in HCV patients.

Main Methods:

  • Review of studies investigating cardiovascular outcomes in patients with chronic Hepatitis C virus infection.
  • Analysis of risk factors such as viral load and steatosis.
  • Examination of molecular and cellular mechanisms including inflammation, oxidative stress, and immune responses.

Main Results:

  • Chronic HCV infection is associated with a higher prevalence of carotid atherosclerosis, with viral load and steatosis as independent risk factors.
  • HCV-related atherosclerosis involves endothelial dysfunction, inflammation (TNF-α, IL-6), oxidative stress (malondialdehyde), and immune dysregulation.
  • HCV infection contributes to cardiomyopathy through direct viral effects on cardiomyocytes and indirect immune-mediated damage, alongside a procoagulant imbalance (elevated Factor VIII).

Conclusions:

  • Substantial evidence links Hepatitis C virus infection to cardiovascular disease, including atherosclerosis and cardiomyopathy.
  • Mechanisms involve direct viral impact, inflammation, oxidative stress, immune responses, and altered coagulation.
  • Further research is required to confirm causality and inform therapeutic strategies for cardiovascular risk in HCV patients.

Keywords:
CardiomyopathyCardiovascular diseaseCarotid atherosclerosisChronic hepatitis CHepatitis C virusImmune dysregulationMyocarditis

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