Hepatitis C Infection May Increase Cardiovascular Risk

People infected with the Hepatitis C virus (HCV) are at risk for liver damage, but the infection may also lead to cardiovascular damage.

A recent study found that participants chronically infected with hepatitis C were more likely to harbor abnormal fat-and-calcium plaques inside their arteries, a condition known as atherosclerosis and a common forerunner of heart attacks and strokes.

Scientists at the Johns Hopkins Bloomberg School of Public Health (Baltimore, MD, USA) and their colleagues assessed 994 men 40 to 70 years old without overt heart disease who were followed across several institutions in Baltimore, Washington DC, Pittsburgh, Los Angeles, and Chicago. Of the 994, 613 were infected with human immunodeficiency virus (HIV), 70 were infected with both viruses and 17 were only infected with hepatitis C. Participants underwent cardiac computed tomography (CT) scans to detect and measure the amount of fat and calcium deposits inside the vessels of their hearts.

Study participants who had higher levels of circulating HCV in their blood were 50% more likely to have clogged arteries, compared with men without hepatitis C. Higher virus levels in the blood signal that the infection is not well controlled by drugs or the immune system. Poorly controlled infection, the investigators added, may lead to more inflammation throughout the body, which can fuel blood vessel damage and thus contribute to heart disease. Those infected with hepatitis C, regardless of HIV status, had, on average, 30% more disease-fueling calcified plaque in their arteries, the main driver of heart attack and stroke risk. People infected with either HIV or hepatitis C, on average, had 42% more non-calcified fatty buildup, a type of plaque believed to confer the greatest cardiac risk.

Eric Seaberg, PhD, assistant professor of epidemiology, and lead investigator, said, “We have strong reason to believe that infection with hepatitis C fuels cardiovascular disease, independent of HIV and sets the stage for subsequent cardiovascular trouble. We believe our findings are relevant to anyone infected with hepatitis C regardless of HIV status.” The authors concluded that chronic HCV infection is associated with subclinical cardiovascular disease, suggesting that HCV-infected individuals warrant vigilant cardiovascular risk assessments. The study was published on July 27, 2015, in the Journal of Infectious Diseases.

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Johns Hopkins Bloomberg School of Public Health