Hepatitis C virus infection associated with coronary and thoracic aortic atherosclerosis

Background

Coronary and thoracic aortic calcification was associated with stroke, coronary heart, and peripheral vascular disease. Hepatitis C virus (HCV) infection is significantly associated with insulin resistance, diabetes mellitus and hepatic steatosis. We aimed to investigate the relationship between HCV infection and coronary, thoracic aortic atherosclerosis.

Materials and methods

Calcification was detected by chest computed tomography and defined as any Agatston score greater than zero. Metabolic syndrome was based on the modified Adult Treatment Panel III criteria. Fibrosis-4 (FIB-4) and AST-to-platelet ratio (APRI) was calculated. The anti-HCV signal-to-cutoff (S/CO) ratio was determined by the third generation ELISA kit. Atherosclerosis risk was estimated by using multiple logistic regression modeling.

Results

Being positive for both metabolic syndrome and HCV infection (OR = 2.65, 95% CI: 1.26–5.59, p = 0.007), negative for metabolic syndrome and positive for HCV infection (OR = 2.75, 95% CI: 1.48–5.30, p = 0.001), and positive for metabolic syndrome and negative for HCV infection (OR = 2.42, 95% CI: 1.92–3.07, p < 0.001) were associated with atherosclerosis compared with being negative for both metabolic syndrome and HCV infection (P_trend< 0.001). HCV infection with liver fibrosis (HCV^FIB4>1.4; OR = 2.16, 95% CI: 1.22–3.82, p = 0.008), or (HCV^APRI>0.5; OR = 3.40, 95% CI: 1.28–9.06, p = 0.014) and elevated anti-HCV S/CO ratio (anti-HCV^S/CO>10.0; OR = 1.72, 95% CI: 1.01–2.93, p = 0.045) was associated with atherosclerosis.

Conclusions

HCV infection with metabolic syndrome, liver fibrosis and elevated anti-HCV S/CO ratio was associated with atherosclerosis.