Hepatitis C virus infection increases risk of peripheral arterial disease in end-stage renal disease patients receiving maintenance hemodialysis therapy

Abstract

Both hepatitis C virus (HCV) infection and end-stage renal disease are associated with an increased risk of developing peripheral arterial disease (PAD). Our objective was to explore the relationship between HCV infection and PAD in hemodialysis patients, using brachial-ankle pulse wave velocity (baPWV) as the assessment method. Since 2016, we have actively been recruiting patients undergoing regular hemodialysis three times a week. All baPWV assessments for our patients were performed before the implementation of direct-acting antiviral treatment. Furthermore, none of the uremic patients with HCV infection had received interferon-based treatment in the past. An elevated baPWV measurement surpassing 2100 cm/s is indicative of an increased susceptibility to potential PAD. Our analysis utilized multivariate linear and logistic regression analysis. Individuals with HCV infection exhibited higher baPWV levels compared with those without HCV infection (2006.0 ± 687.4 vs. 1809.3 ± 466.1 cm/s, p = .039). The presence of HCV infection (β = 199.56, 95% CI: 10.56–388.56, p = .039) demonstrated a significantly positive correlation with baPWV levels. In the multivariate logistic regression analysis, HCV infection (OR = 2.67, 95% CI: 1.07–6.68, p = .036) significantly associated with baPWV >2100 cm/s. Furthermore, individuals with a higher viral load (HCV RNA ≥60 × 10³ IU/mL) (OR = 4.45, 95% CI: 1.12–17.68, p = .034) demonstrated a significant association with baPWV ≥2100 cm/s when compared with non-HCV infection patients. Additionally, patients with genotype I exhibited a significant association with baPWV ≥2100 cm/s (OR = 8.13, 95% CI: 2.04–32.42, p = .003) in comparison to non-HCV patients. The presence of HCV infection has been demonstrated to markedly increase baPWV levels. Particularly, HCV infection with higher viral load and genotype I is significantly linked to an elevated risk of PAD. It emphasizes the importance of HCV elimination in the specific population.