1Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France.
2AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, F-75013, Paris, France.
3INSERM, UMR-S 959, F-75013, Paris, France.
4CNRS, FRE3632, F-75005, Paris, France.
Among the large scope of extrahepatic manifestations related to hepatitis C virus (HCV) infection, many studies recently evaluated the frequency and characteristics of cardiovascular involvement.
To assess the current published data on HCV infection and cardiovascular diseases.
Published studies on cardiovascular disease, i.e. cerebrovascular accident and ischemic heart disease in subjects with HCV infection were analyzed from literature databases.
Subjects with HCV chronic infection have an increased prevalence of carotid atherosclerosis and increased intima-media thickness compared to healthy controls or those with hepatitis B or nonalcoholic steatohepatitis. Active chronic HCV infection appears as an independent risk factor for ischemic cerebrovascular accidents. Active chronic HCV infection is associated with increased risk of ischemic heart disease. In some studies, successful interferon-based therapy showed a beneficial impact on the cardiovascular risk.
The risk of major cardiovascular events is higher in patients with HCV infection compared to controls, independent of the severity of the liver disease or the common cardiovascular risk factors. The beneficial impact of interferon-based therapy needs to be confirmed with new direct antiviral interferon-free agents in prospective studies with extended follow-up.