Cardiovascular Manifestations of Hepatitis C Virus

Clin Liver Dis. 2017 Aug;21(3):465-473. doi: 10.1016/j.cld.2017.03.003. Epub 2017 Apr 21.

Abstract

Hepatitis C virus (HCV) infection is a prevalent condition associated with numerous extrahepatic manifestations. Epidemiologic studies have found that HCV is associated with increased cardiovascular morbidity and mortality, in particular with carotid atherosclerosis, cerebrovascular events, and coronary heart disease. The mechanisms involved encompass a chronic systemic inflammatory state, insulin resistance, and a potential, direct infection of the vascular endothelium. Sustained virologic response with interferon-based regimens is associated with reduced cardiovascular events, although this must be validated with newer direct-acting antivirals. This clear association between HCV and cardiovascular events may have significant economical and public health implications.

Keywords: Cardiovascular mortality; Carotid atherosclerosis; Coronary artery disease; Hepatitis C virus; Peripheral artery disease; Stroke.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Carotid Artery Diseases / epidemiology
  • Cerebrovascular Disorders / epidemiology
  • Hepacivirus*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / economics
  • Hepatitis C, Chronic / epidemiology*
  • Humans
  • Insulin Resistance
  • Interferons / therapeutic use
  • Sustained Virologic Response

Substances

  • Antiviral Agents
  • Interferons