Friday, May 13, 2016

Chronic Hepatitis C Virus Infection, a New Cardiovascular Risk Factor?

Chronic Hepatitis C Virus Infection, a New Cardiovascular Risk Factor?
Fanny Domont; Patrice Cacoub

Liver International. 2016;36(5):621-627.

In addition to common cardiovascular risk factors (i.e. diabetes, hypertension, obesity, smoking, dyslipidemia, etc.), there appears to be new risk factors associated with certain infectious agents. Several infectious agents, notably Chlamydia pneumoniae, Cytomegalovirus and Human Immunodeficiency Virus (HIV), have been associated with the occurrence of cardiovascular manifestations. Hepatitis C virus (HCV) infection has been associated to a very large number of extrahepatic manifestations in various tissues and organs.[1…6] Some authors have hypothesized that infections could contribute to the inflammatory cascade and result in atherosclerosis.[7] Associations have been found between HCV infection and cardiomyopathies;[8,9] coronary[10,11] or carotid[12,13] atherosclerosis; and hypertension.[14] A recent epidemiological study showed that blood donors who were seropositive for HCV had higher mortality rates for cardiovascular diseases than non-HCV-infected blood donors without comorbidities.[15] The pathogenic mechanisms connecting HCV infection, chronic liver disease and atherogenesis are not completely understood. It has been hypothesized that HCV may promote atherogenesis and its complications through several direct and indirect biological mechanisms involving HCV colonization and replication within arterial walls, liver steatosis and fibrosis, enhanced and imbalanced secretion of inflammatory cytokines, oxidative stress, endotoxemia, perturbed cellular and humoral immunity, hyperhomocysteinemia, insulin resistance, type 2 diabetes…

As cardiovascular risk factors rates increase with age and patients with HCV chronic infection ageing, it seems of major interest to assess the impact of HCV infection on the occurrence of cardiovascular events. This review assesses the current published data on HCV infection and cardiovascular diseases.

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  • Abstract and Introduction
  • HCV Infection and Carotid Atherosclerosis
  • HCV Infection and Cerebrovascular Involvement
  • HCV Infection and Ischaemic Heart Disease
  • Cardiovascular Disease-related Mortality in HCV-infected Patients
  • Impact of HCV Treatment on Cardiovascular Outcomes
  • Conclusion
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