Hepatitis C virus infection associated with coronary and thoracic aortic atherosclerosis

Chih-Wen Wang; Chung-Feng Huang; Ming-Lun Yeh; Szu-Chia Chen; Chih-Hsing Hung; Chao-Hung Kuo; Jee-Fu Huang; Chia-Yen Dai; Wan-Long Chuang; Ming Lung-Yu

doi:10.1016/j.amjms.2024.02.004

Hepatitis C virus infection associated with coronary and thoracic aortic atherosclerosis

Am J Med Sci. 2024 Feb 16:S0002-9629(24)01063-2. doi: 10.1016/j.amjms.2024.02.004. Online ahead of print.

Authors

Affiliations

¹ Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁴ Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: fish6069@gmail.com.

PMID: 38368945
DOI: 10.1016/j.amjms.2024.02.004

Abstract

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.

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.

Keywords: HCV; atherosclerosis; liver fibrosis; metabolic syndrome; signal-to-cutoff ratio.