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Chronic HCV influences subclinical CVD
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A link between chronic hepatitis C virus infection and subclinical cardiovascular disease indicated a need for thorough and ongoing cardiovascular risk assessments among patients with the infection, according to recent data.
In the cross-sectional study, researchers evaluated 994 HIV-infected and -uninfected men enrolled in the Multicenter AIDS Cohort Study (MACS). Patient data were gathered at study entry and semiannual visits through questionnaires and physical examinations. Biological samples also were collected for testing and repository storage.
Patients involved in active follow-up during January 2010 were invited for coronary plaque scanning using noncontrast CT as a component of the MACS cardiovascular ancillary study. Patients were aged 40 to 70 years, had no history of cardiac surgery or percutaneous coronary intervention and weighed less than 300 pounds. The researchers also performed coronary contrast CT angiography on a subset of 755 men without contrast allergy, renal impairment or atrial fibrillation at CT scanning. Correlations between chronic hepatitis C (CHC) and HIV with plaque rate, severity and stenosis also were evaluated.
After adjusting for demographics, HIV serostatus, behavioral factors and CVD risk, there was a significant link between CHC and a higher rate of coronary artery calcium (CAC, prevalence ratio, 1.29; 95% CI, 1.02-1.63), any plaque (1.26; 95% CI, 1.09-1.45) and noncalcified plaque (1.42; 95% CI, 1.16-1.75). An independent link also was established between CHC or HIV and the rate of any and noncalcified plaque, but no indication was seen of a symbiotic effect resulting from HIV/HCV coinfection. Compared with men without CHC, patients with HCV RNA greater than or equal to 2 x 106 IU/mL had significantly higher rates of CAC, any plaque, noncalcified plaque, mixed plaque and calcified plaque.
“The elevated prevalence of subclinical coronary atherosclerosis among men with chronic HCV infection, especially men with the highest HCV RNA levels, provides further evidence supporting a link between chronic HCV infection and cardiovascular disease,” the researchers wrote. “Future research is needed to confirm our novel finding of an association between higher HCV RNA level and atherosclerosis, and to determine whether duration of HCV infection or the use of curative HCV treatment impacts the formation or progression of coronary plaque.” – by Jen Byrne
Disclosure: McKibben reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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