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Hepatitis C Virus Infection is Associated With Increased Cardiovascular Mortality: A Meta-analysis of Observational Studies
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[from Jules Levin, NATAP: this study was just published......just below several excerpts are links to a number of studies showing the association between HCV 7 cardiovascular diseases and HCV and also other extra hepatic manifestations & HCV including kidney disease and cancers.]
"clinical studies have shown a higher prevalence of metabolic disorders that are CVD risk factors, specifically type 2 diabetes mellitus (DM) [9], insulin resistance [10], and hepatic steatosis [11], in HCV patients compared to uninfected controls. Moreover, recent data have identified HCV infection as a risk factor for subclinical [12-26] and clinical cardiovascular alterations [27-45]. However, the results of these published studies have been inconsistent, and the overall impact of HCV infection on CVD-related morbidity and mortality is difficult to evaluate.
Considering the availability of new antiviral therapeutic strategies with increased effectiveness and excellent tolerability profiles, a definitive estimate of the impact of HCV infection on CVD-related risk is strongly needed [46]. Therefore, the aim of this meta-analysis was to estimate whether patients infected with HCV, compared to uninfected controls, evidenced increased rates of CVD-related mortality, carotid atherosclerosis, and cerebro-cardiovascular (CCV) events.
This meta-analysis of aggregate data from 22 studies shows that compared to uninfected controls, HCV-infected individuals have increased risks of CVD-related mortality and subclinical carotid atherosclerosis. We observed a slightly significant increase in CCV events among HCV-infected patients, despite the high heterogeneity among studies that was mostly related to the prevalence of DM and hypertension.
Historically, HCV infection has been considered to affect only the liver, via the development of cirrhosis and its complications. HCV infection has also been shown to increase the risk of overall mortality and the occurrence of extrahepatic complications, such as lymphoproliferative disorders and metabolic alterations (insulin resistance and DM). However, recent studies have suggested that HCV-infected patients have an increased risk of developing CVDs [12-45]. To our knowledge, our meta-analysis clearly highlights, for the first time, that HCV infection increases the risk of CVD-related mortality."
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New Study - SVR Reduces Liver Mortality & Morbidity by 75% and CVD Hospitaliztion by 30%......http://www.natap.org/2015/HCV/090415_05.htm....patients with SVR exhibited >75% reduced risk of liver mortality and SLM (severe liver morbidity), relative to patients without SVR......We report an association between SVR and a 32% risk reduction in non liver mortality.......A second result to emphasize is the association between SVR and a 30% reduction in the risk of hospitalization for CVD, this finding provides further evidence that HCV infection is a risk factor for cardiovascular impairment
Heart Disease in HCV+......http://www.natap.org/2014/HCV/060314_02.htm......HCV+ normotensive patients, in comparison with healthy normotensive subjects, have a significant increase in echocardiographic cardiac mass, totally similar to that observed in hypertensive patients.......IR/hyperinsulinemia HCV-related, by affecting cardiac remodeling, suggests considering chronic HCV infection as a possible new factor in the global cardiovascular risk burden
HCV Extrahepatic
Mortality-kidney/heart/cancers.....http://www.natap.org/2014/HCV/060114_05.htm......if a person had HCV with detectable viral load which almost everryone does, risk for death due to liver related disease increased a lot, risk for extrahepatic disease (kidney, cancers, heart disease, circulatory diseases increased.
Chronic Hepatitis C Virus Infection Increases Mortality From Hepatic and Extrahepatic Diseases: A Community-Based Long-Term Prospective Study - (R.E.V.E.A.L.)-HCV study.......http://www.natap.org/2012/HCV/071912_01.htm.......HCV infection was found to be associated with deaths from hepatic and extrahepatic diseases, particularly for those with detectable serum HCV RNA.......increased risk for those with detectable HCV viral load all causes of death; 12.48, for hepatic diseases; 1.35 (1.15-1.57), for extrahepatic diseases; 1.50 (1.10-2.03), for circulatory diseases [heart disease] ; 2.77 (1.49-5.15) for nephritis, nephrotic syndrome, and nephrosis; 4.08 (1.38-12.08) for esophageal cancer; 4.19 (1.18-14.94) for prostate cancer; and 8.22 (1.36-49.66) for thyroid cancer......In this prospective study, HCV infection was associated with an increased mortality from extrahepatic diseases, including circulatory diseases and renal diseases. Chronic HCV infection was associated with an increased (1.4-fold) mortality from circulatory diseases, which was consistent with other reports in Western countries [3, 20]. We have reported that HCV infection was associated with cerebrovascular death after considering for conventional risk factors. The dose-response relationship between serum HCV RNA level and the risk of cerebrovascular death further strengthened the causal association of HCV infection and atherosclerosis [21]. HCV infection may play as a stimulus for atherothrombosis by triggering a cascade of immune and inflammatory responses, either locally within vascular tissue or systematically through inflammatory mediators [22].
SVR Improves Steatosis in GT-3..... Associations of chronic hepatitis C with metabolic and cardiac outcomes.....http://www.natap.org/2015/HCV/091415_08.htm
Associations of chronic hepatitis C with metabolic and cardiac
outcomes........http://www.natap.org/2015/HCV/apt12234.pdf
Chronic Hepatitis C Virus Infection Is Associated with Subclinical Coronary Atherosclerosis in the Multicenter AIDS Cohort Study (MACS): a Cross-Sectional Study......http://www.natap.org/2015/HCV/McKibben-infdis_jiv396.pdf
The risk of cardiovascular disease and death over 10 years in HIV/HCV co-infected patients with and without steatosis ....mortality was high .....high rates of cardiovascular disease.......http://www.natap.org/2015/IAS/IAS_105.htm
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Hepatitis C Virus Infection is Associated With Increased Cardiovascular Mortality: A Meta-analysis of Observational Studies
Gastroenterology Oct 2015
Salvatore Petta, Marcello Maida, Fabio Salvatore Macaluso, Marco Barbara, Anna Licata, Antonio Craxi, Calogero Camma
Abstract
Background & Aims
There have been many studies of the effects of hepatitis C virus (HCV) infection on cardiovascular risk, but these have produced ambiguous results. We performed a meta-analysis of these studies to systematically assess the risk of HCV infection on cardiovascular disease (CVD)-related morbidity and mortality.
Methods
We searched PubMed Central, Medline, Embase, and Cochrane Library, as well as reference lists of articles, for studies published through July 2015 that compared the occurrence of CVD between HCV-infected and uninfected subjects, or assessed the prevalence of HCV infection among subjects with CVDs. In total, 22 studies were analyzed. Data on the patient populations and outcomes were extracted from each study by 3 independent observers and combined by a random-effects model.
Results
Compared to uninfected individuals (controls), HCV-infected patients had increased risks of CVD-related mortality (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.07-2.56; P=.02), carotid plaques (OR, 2.27; 95% CI, 1.76-2.94; P<.001), and cerebro-cardiovascular events (OR, 1.30; 95% CI 1.10-1.55; P=.002). Significant heterogeneity was observed in the risk of cerebrocardiovascular disease among individuals with HCV infection. The effect of HCV infection on cerebrocardiovascular disease was stronger in populations with a higher prevalence of diabetes (>10%) or hypertension (>20%) (OR, 1.71; 95% CI, 1.32-2.23; P<.001 for both).
Conclusion
In a meta-analysis of published studies, individuals with HCV infections were found to be at increased risk for CVD-related morbidity and mortality-especially those with diabetes and hypertension.
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