Hepatitis C virus infection and risk of stroke: a systematic review and meta-analysis

PLoS One. 2013 Nov 12;8(11):e81305. doi: 10.1371/journal.pone.0081305. eCollection 2013.


Background/aims: Several studies analyzed the association between hepatitis C virus (HCV) infection and the risk of stroke or cerebrovascular death, but their findings were inconsistent. Up to date, no systematic review about the association between HCV infection and stroke was performed. We conducted a meta-analysis to examine whether HCV infection dose increase stroke risk in comparison to the population without HCV infection.

Methods: We followed standard guidelines for performance of meta-analysis. Two independent investigators identified eligible studies through structured keyword searches in several databases. Random-effects and fixed-effects models were used to synthesize the data. Heterogeneity between studies and publication bias were also accessed.

Results: Combining the data from the eligible studies, we calculated the pooled multi-factor adjusted Odds Ratio (OR) with 95% confidence interval (CI). Upon the heterogeneity found between studies, the result was 1.58 (0.86, 2.30) by random-effects model. However, after omitting the study which induced heterogeneity, the pooled OR with 95% CI was 1.97 (1.64, 2.30).

Conclusions: This meta-analysis suggested that HCV infection increased the risk of stroke. More prospective cohort studies will be needed to confirm this association with underlying biological mechanisms in the future.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Hepacivirus*
  • Hepatitis C / complications*
  • Humans
  • Odds Ratio
  • Publication Bias
  • Risk*
  • Stroke / complications*
  • Stroke / epidemiology*

Grant support

The authors have no support or funding to report.