Effects of Hepatitis C virus on cardiovascular risk in infected patients: A comparative study

Abstract

The role of hepatitis C virus (HCV) in the pathogenesis of atherosclerosis and cardiovascular events is unclear. The aim of this study was to evaluate the direct effect of HCV on cardiovascular risk and correlate it with pro and anti-inflammatory cytokines in patients with HCV. HCV monoinfected patients, genotype 1, naive, non-obese (BMI<30) and non-diabetics were included and compared to controls (blood donors). Patients with prior diagnosis of cardiovascular diseases, hypertension, chronic renal failure, cancer and chronic use of lipid-lowering drugs or immunosuppressants were excluded. Age, BMI, systolic blood pressure (SBP) and diastolic (DBP), fasting glucose and lipid levels were determined. Serum cytokines (IL-6, IL-10 and TNF-α) and Framingham score were also evaluated. 62 HCV patients, 34 (54.8%) were males and none of them was smoking. The Framingham scores (median and 25th and 75th percentiles) were 12% (6.5-14%), showing an intermediate cardiovascular risk in patients with HCV. There was significant direct correlation between Framingham and total cholesterol (p=0.043) and DBP (p=0.007). HDL-C (p=0.002) was inversely correlated with the Framingham score. HCV patients had higher levels of proinflammatory cytokines (IL-6 and TNF-α) compared to controls (p<0.0001) and the relation of proinflammatory/anti-inflammatory TNF-α/IL10 and IL-6/IL10 were higher in HCV patients (p<0.01). The Framingham score was directly correlated to IL-6 and TNF-α, but differences were not statistically significant. Patients with HCV monoinfected, nonobese, naïve and non diabetic have an intermediate cardiovascular risk, as measured by the Framingham score and high levels of proinflammatory cytokines (IL-6 and TNF).

Hepatitis C Virus Infection in the Older Patient

“…42 The mechanisms by which HCV infection might be associated with cardiovascular disease include an HCV-induced pro-inflammatory state 43 and possible direct effects of the virus on the myocardium and endothelium. 44 HCV infection is also associated with a higher prevalence of DM, a well-known risk factor for CVD.…”

Association of HIV, hepatitis C virus and liver fibrosis severity with interleukin-6 and C-reactive protein levels

“…[3-5] C-reactive protein (CRP) is a widely used clinical marker of inflammation. The inflammatory marker interleukin-6 (IL-6) is a potent stimulator of CRP production in the liver and has also been associated with vascular disease and death,[6-8] but is generally not tested on a clinical basis.…”

Investigation of Mean Platelet Volume in People with Chronic Hepatitis C Virus Infection

“…Ayrıca HCV; diabetes mellitus, metabolik sendrom ve hepatik steatoz gibi kardiyovasküler hastalıklar için önemli risk faktörleri sayılan metabolik komplikasyonlarla da ilişkili bulunmuştur. 16,24 Karotis intima-media kalınlığı (KİMK) aterosklerotik değişikliklerin önemli bir göstergesi-dir. 25 HCV enfeksiyonu olan hastalarda karotis plağı ve KİMK ölçümlerinin yapıldığı çalışmaları sunan bir derlemede, karotis aterosklerotik plak varlığı ve KİMK, HCV enfeksiyonu olmayanlara göre daha yüksek bulunmuştur.…”