Hepatitis C virus infection was an independent risk predictor of cerebrovascular (Stroke) deaths

Cerebrovascular disease is a group of brain dysfunctions related to disease of the blood vessels supplying the brain.

Hepatitis C increased risks for cerebrovascular-related death
Lee M. Stroke. 2010;doi:10.1161/STROKEAHA.110.598136.
Download the PDF Here

Hepatitis C virus infection was an independent risk predictor of cerebrovascular deaths, indicating a biological gradient of cerebrovascular mortality with increasing serum hepatitis C virus RNA levels, researchers said.
The study included residents (n=23,665, aged 30 to 65 years) from a community-based prospective cohort who were enrolled from 1991 to 1992. Residents answered structured questionnaires and provided blood samples for various serological and biochemical tests at study entry. Researchers tested serum hepatitis C virus (HCV) RNA level and HCV genotype for participants seropositive for antibodies against HCV (anti-HCV

During the 382,011 person-years of follow-up, researchers reported 255 cerebrovascular deaths, which translated into a cumulative risk for cerebrovascular deaths of 1% for seronegatives and 2.7% for seropositives of anti-HCV (P<.001). The corresponding multivariate-adjusted HR for cerebrovascular death was 2.18 (95% CI, 1.50-3.16) for anti-HCV seropositives. In additional analysis, compared with patients seronegative for anti-HCV, the multivariate-adjusted HR for anti-HCV-seropositive participants with undetectable serum levels of HCV RNA was 1.40 (95% CI, 0.62-3.16), 2.36 (95% CI, 1.42-3.93) for low serum levels and 2.82 (95% CI, 1.25-6.37) for high serum levels (P<.001 for trend). “HCV infection is associated with an increased risk of cerebrovascular mortality, particularly for those with elevated serum HCV RNA levels,” the researchers concluded. “If future additional studies confirm the role of HCV infection and the development of cerebrovascular disease, it may be possible to prevent cerebrovascular disease by using specific antiviral strategies.” http://www.cardiologytoday.com/view.aspx?rID=77013


Stroke. 2010 Oct 21. [Epub ahead of print]

Hepatitis C Virus Infection and Increased Risk of Cerebrovascular Disease.
Lee MH, Yang HI, Wang CH, Jen CL, Yeh SH, Liu CJ, You SL, Chen WJ, Chen CJ.

From the Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan; the Genomics Research Center, Academia Sinica, Taipei, Taiwan; the Department of Cardiology, Cardinal Tien Hospital, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan; the Department of Microbiology, National Taiwan University, Taipei, Taiwan; and the Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Abstract
BACKGROUND AND PURPOSE: The association between hepatitis C virus (HCV) infection and cerebrovascular disease remains controversial. This study aimed to assess the risk of lethal cerebrovascular diseases associated with chronic HCV infection.

METHODS: In this community-based prospective cohort study, 23 665 residents (aged 30 to 65 years) were enrolled in 1991 to 1992. They were personally interviewed using structured questionnaires and provided blood samples for various serological and biochemical tests at study entry. Serum HCV RNA level and HCV genotype were tested for participants seropositive for antibodies against HCV (anti-HCV). Deaths from cerebrovascular disease during follow-up were ascertained by computerized linkage with National Death Certification profiles from 1991 to 2008 (International Classification of Diseases, 9th Revision 430 to 438). Multivariate-adjusted hazard ratio with 95% CI was estimated for each risk predictor.

RESULTS: There were 255 cerebrovascular deaths during 382 011 person-years of follow-up. The cumulative risk of cerebrovascular deaths was 1.0% and 2.7% for seronegatives and seropositives of anti-HCV, respectively (P less then0.001). The hazard ratio (95% CI) of cerebrovascular death was 2.18 (1.50 to 3.16) for anti-HCV seropositives after adjustment for several conventional risk factors of cerebrovascular disease. Compared with participants seronegative for anti-HCV as the referent, the multivariate-adjusted hazard ratio (95% CI) was 1.40 (0.62 to 3.16), 2.36 (1.42 to 3.93), and 2.82 (1.25 to 6.37), respectively, for anti-HCV-seropositive participants with undetectable, low, and high serum levels of HCV RNA (P less then 0.001>
.
CONCLUSIONS: Chronic HCV infection is an independent risk predictor of cerebrovascular deaths showing a biological gradient of cerebrovascular mortality with increasing serum HCV RNA level.

PMID: 20966408 [PubMed - as supplied by publisher]