Hepatitis C and risk of coronary atherosclerosis - A systematic review

Abstract

Background: Observational studies on the association of chronic hepatitis C with coronary atherosclerosis have shown varying results and previous related reviews have been inconclusive. By careful outcome classification and further data syntheses, we aimed to clarify current evidence on the association between hepatitis C infection and coronary atherosclerosis.

Methods: Through systematic searches of PubMed and Scopus, related published observational studies were identified. These were narrowed by review of abstract, full review and quality assessment to yield eligible studies. These were used in qualitative and quantitative syntheses.

Results: The initial search identified 274 unique publications, which were narrowed to 15 by means of preliminary reviews, and narrowed further to 10 by quality assessment. The endpoints assessed varied, representing different attributes of the disease. The 10 studies were used in the subsequent meta-analyses. The risk of a person with chronic hepatitis C developing coronary atherosclerosis is about triple the risk in uninfected persons (OR = 3.06, 95% CI = 1.99-4.72). Coronary atherosclerosis in persons with chronic hepatitis C is also more severe. The pooled risk of coronary atherosclerosis-related events in persons with chronic hepatitis C was null (OR = 1.10 95% CI = 0.80-1.52).

Conclusion: The current evidence indicates that hepatitis C virus or factors associated with HCV infection are apparently associated with increased risk of occurrence of coronary atherosclerosis and probably, increased severity of coronary atherosclerosis. Evidence of association with coronary atherosclerosis-related events is yet indeterminate.

Keywords: Coronary artery disease; HCV; Inflammation; Meta-analysis; Myocardial infarction.