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. 2016 Jan;46(1):63-70.
doi: 10.1111/imj.12936.

The association between chronic hepatitis C infection and cardiovascular risk

P Pateria  1 , G P Jeffrey  1   2 , G MacQuillan  1   2 , D Speers  3 , H Ching  1   2 , M A Chinnaratha  1 , G F Watts  2   4 , L A Adams  1   2
Affiliations

The association between chronic hepatitis C infection and cardiovascular risk

P Pateria et al. Intern Med J. 2016 Jan.

Abstract

Background: Vascular disease is a common cause of death in patients with chronic hepatitis C (CHC) infection; however, the association between CHC and atherosclerosis is unclear.

Aims: To determine whether patients with CHC have increased subclinical vascular disease and whether genotype or antiviral treatment modifies this risk.

Methods: Fifty CHC patients and 22 age-matched and sex-matched healthy controls underwent clinical and biochemical assessment for vascular risk factors. In addition, vascular risk was assessed by measuring arterial stiffness (aortic augmentation index and carotid-femoral pulse wave velocity (PWV)), endothelial dysfunction (brachial artery flow-mediated dilatation (FMD) and dilatation post-glycerol trinitrate administration) and carotid intima-media thickness (CIMT). Assessment was repeated in subset of CHC patients (n = 12) undergoing antiviral treatment 18 months after initiation of treatment.

Results: Baseline vascular risk factors and measures of arterial stiffness, endothelial dysfunction and CIMT were not different between cases and controls (P > 0.2 for all). Genotype 1 CHC patients had greater endothelial dysfunction with lower FMD (8.2 ± 3.5% vs 10.9 ± 5.2%, P = 0.03) and higher right CIMT (0.6 ± 0.1 mm vs 0.5 ± 0.07 mm, P = 0.04) compared with non-genotype 1. Patients who achieved sustained virological response (7/12) showed significant improvement in insulin resistance (homeostasis model of assessment of insulin resistance 2.3 ± 1.2 vs 1.8 ± 0.8, P = 0.02) and arterial stiffness (PWV 7.4 ± 1.1 m/s vs 6.5 ± 0.6 m/s, P = 0.04).

Conclusions: Subclinical vascular disease is not greater in CHC subjects compared with controls. However, among CHC subjects, genotype 1 infection is associated with greater endothelial dysfunction and increased carotid-intima medial thickness compared with non-genotype 1 infection. Successful viral eradication may improve insulin resistance and arterial stiffness.

Keywords: atherosclerosis; carotid intima-media thickness; chronic hepatitis C; insulin resistance; pulse wave velocity.

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Comment in

  • Associated factors with atherosclerosis in hepatitis C infection.
    Ozturk K, Demirci H, Kurt O, Kantarcioglu M. Ozturk K, et al. Intern Med J. 2016 Jul;46(7):862-3. doi: 10.1111/imj.13033. Intern Med J. 2016. PMID: 27405899 No abstract available.
  • Author reply.
    Pateria P, Jeffrey GP, MacQuillan G, Speers D, Ching H, Chinnaratha MA, Watts GF, Adams LA. Pateria P, et al. Intern Med J. 2016 Jul;46(7):863. doi: 10.1111/imj.13119. Intern Med J. 2016. PMID: 27405900 No abstract available.

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