Thromboembolic Events Among Patients with Hepatitis C Virus Infection and Cirrhosis: A Matched-Cohort Study

Enger, Cheryl; Forssén, Ulla M.; Bennett, Dimitri; Theodore, Dickens; Shantakumar, Sumitra; McAfee, Andrew T.

doi:10.1007/s12325-014-0138-4

Cited by 44 publications

(58 citation statements)

References 27 publications

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“…In general, it is our findings with respect to T1MI that are likely to be most comparable to prior studies of this question, which in the general population have not found an association between chronic HCV infection and MI (30)(31)(32)(33). Two prior studies in PLWH were inconclusive.…”

Section: Discussionsupporting

confidence: 78%

“…Observational evidence supports an association between HCV and clinically evident CVD, in both the general population (27,28) and in PLWH (29). Yet studies in the general population focusing on the role of HCV in coronary artery disease risk are inconclusive (27) and, when restricting to MI only, have generally not supported an association (30)(31)(32)(33). One recent study found a higher risk of MI in those with HCV but only among the subgroup with high levels of total and low density lipoprotein (LDL) cholesterol (34).…”

Section: Word Count: 2736 Wordsmentioning

confidence: 99%

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Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Williams-Nguyen¹,

Hawes

Nance

et al. 2018

Preprint

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Hepatitis C virus (HCV) is common among people living with HIV (PLWH). The potential for extrahepatic manifestations of HCV, including myocardial infarction (MI), is a topic of active research. MI is classified into types, predominantly atheroembolic Type 1 MI (T1MI) and supply-demand mismatch Type 2 MI (T2MI). We examined the association between HCV and MI in the CFAR Network of Integrated Clinical Systems (CNICS), a multi-center clinical cohort of PLWH. MIs were centrally adjudicated and categorized by type using the Universal MI definition. We estimated the association between chronic HCV (RNA+) and time to MI adjusting for demographic characteristics, cardiovascular risk factors, clinical characteristics and substance use. Among 24,755 PLWH aged ≥18, there were 336 T1MI and 330 T2MI during a median of 4.2 years of follow-up. HCV was associated with a 68% greater risk of T2MI (adjusted hazard ratio (aHR) 1.68, 95% CI: 1.22, 2.30) but not T1MI (aHR 0.96, 95% CI: 0.63, 1.45). In a cause-specific analysis of T2MI, HCV was associated with a 2-fold greater risk of T2MI attributed to sepsis (aHR 2.26, 95% CI: 1.34, 3.81). Extrahepatic manifestations of HCV in this high-risk population are an important area for continued research.

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Section: Discussionsupporting

confidence: 78%

Section: Word Count: 2736 Wordsmentioning

confidence: 99%

Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Williams-Nguyen¹,

Hawes

Nance

et al. 2018

Preprint

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“…Развитие цереброваскулярной патологии может существенно влиять на прогноз и исход заболевания. Так, несколько независимых исследовательских групп пришли к заключению, что частота наступления летального исхода вследствие цереброваскулярных нарушений среди больных ХВГС как минимум в 2 раза выше, чем среди неинфицированных лиц [7,8]. Результаты еще одного метаанализа последних исследований в данной области свидетельствуют о наличии высокого риска развития инсульта у больных хронической HCV-инфекцией (ОР = 1,97; 95% ДИ: 1,64-2,30) [9].…”

Section: результатыunclassified

Clinical epidemiology of extrahepatic manifestations of chronic hepatitis C virus infection

2020

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Extrahepatic manifestations occur in more than half of patients with chronic hepatitis C virus infection and may be no less dangerous to the health and life of the patient than the isolated pathology of the liver. Chronic hepatitis C virus infection is often accompanied by the formation of neurocognitive disorders, clinically manifested by general weakness, fatigue and the inability to maindoi tain concentration for a long time. Every fifth patient with chronic hepatitis C develops depression. The development of type 2 diabetes among patients with chronic hepatitis C virus infection is observed 1.7 times more often than among non-infected individuals. Mixed cryoglobulinemia is observed in at least 30% of patients, however, the clinical manifestations of this pathology develop only in 4.9% of cases, of which 69–89% of skin lesions, 19–44% of distal sensory and sensorimotor polyneuropathy, 30% of membranoproliferative glomerulonephritis, 28% of joint damage. Among patients with chronic hepatitis C virus infection, higher prevalence than among non-infected individuals is observed, the prevalence rates of such nosologies as lymphoma from cells of the marginal zone are 2.47 times, diffuse large cell B cell lymphoma – 2.24 times, hypothyroidism – 3.1 time. Significantly more rarely encountered extrahepatic manifestations of chronic hepatitis C virus infection are skin lesions that are not associated with the development of cryoglobulinemic vasculitis: acquired late skin porphyria, necrolytic acral erythema and lichen planus. The question of the pathogenetic relationship of chronic hepatitis C virus infection with cardiovascular pathology remains open.

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“…A relationship between advanced HCV infection and prothrombotic state has been extensively reported involving different mechanisms (systemic inflammation, increased thrombin generation, enhanced platelets aggregation, etc…) and a correlation between the procoagulant imbalance and impaired liver function has been shown . In contrast, scanty data are available in patients without cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Procoagulant imbalance influences cardiovascular and liver damage in chronic hepatitis C independently of steatosis

Sigon

D’Ambrosio

Clerici

et al. 2019

Liver International

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Background & Aims:Patients with chronic HCV infection besides hepatitis often present cardiovascular damage, the pathogenesis of which is not defined. In chronic liver diseases, including NAFLD and cirrhosis, a procoagulant imbalance, potentially responsible for atherosclerosis has been reported. We aimed at evaluating whether a procoagulant imbalance is present also in non-cirrhotic patients with HCV infection and whether the procoagulant imbalance correlates with cardiovascular damage.The correlation between the procoagulant imbalance, coexisting steatosis, and liver fibrosis was analysed.Methods: From 2014 to 2018, 393 subjects (205 patients with chronic HCV infection from two liver units and 188 controls) were enrolled. Metabolic, cardiovascular, liver assessment and coagulation parameters-procoagulants (FII and FVIII) and anticoagulants (antithrombin and protein C [PC]), endogenous thrombin potential (ETP), peak-thrombin and their ratios (with/without thrombomodulin)-were determined. Results:The procoagulant imbalance (defined as high FVIII, FVIII/PC ratio, ETP-ratio and peak-thrombin-ratio (with/without thrombomodulin)) was significantly higher in patients with chronic HCV than controls. Steatosis was detected in 87 patients (42%).No difference in coagulation imbalance, carotid and cardiac parameters and severity of liver fibrosis was observed in patients with or without steatosis, despite the latter had less severe metabolic alterations. The FVIII/PC ratio was independently associated with carotid intima-media thickness (coefficient 0.04, 95% CI 0.002-0.07, P = .04) and liver fibrosis (coefficient 0.64, 95% CI 0.37-0.92, P < .0001). Conclusion: Patients with HCV infection, even in the absence of cirrhosis have a procoagulant-imbalance that possibly plays a role in increasing the risk of cardiovascular disease and progression of fibrosis. How to cite this article: Sigon G, D'Ambrosio R, Clerici M, et al. Procoagulant imbalance influences cardiovascular and liver damage in chronic hepatitis C independently of steatosis. Liver

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Thromboembolic Events Among Patients with Hepatitis C Virus Infection and Cirrhosis: A Matched-Cohort Study

Abstract: Patients with HCV and cirrhosis of various etiologies are at increased risk of several types of thromboembolic events. Physicians should consider this increased risk when managing patients with liver disease.

Cited by 44 publications

References 27 publications

Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Clinical epidemiology of extrahepatic manifestations of chronic hepatitis C virus infection

Procoagulant imbalance influences cardiovascular and liver damage in chronic hepatitis C independently of steatosis

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