Hepatitis C May Increase Risk of Heart Disease

Positive hepatitis C infection may increase risk for liver damage as well as future heart problems, according to findings published in The Journal of Infectious Diseases.

Researchers from Johns Hopkins Medicine evaluated almost 1,000 men aged 40 to 70 years with or without human immunodeficiency virus (HIV), of which 87 also had hepatitis C in order to measure associations between hepatitis C with coronary atherosclerosis. About 750 men participating in the study also underwent CT angiography. The participants, who did not have overt existing heart disease, were recruited from the Multicenter AIDS Cohort Study, a larger study focused on men who have sex with men.

Prior research demonstrated that people with HIV already have an elevated risk for heart disease, but the researchers believe their findings here offer strong support for hepatitis C also contributing to cardiovascular damage independent of HIV status.

The investigators found that patients infected with hepatitis C are more likely to have atherosclerosis, which they cite as a common signal of future heart attacks or strokes. After adjusting for various demographic characteristics, HIV serostatus, behaviors, and cardiovascular risk factors, chronic hepatitis C infection was what the researchers called “significantly associated” with a higher prevalence of both coronary artery calcium and noncalcified plaque.

“We have strong reason to believe that infection with hepatitis C fuels cardiovascular disease, independent of HIV and sets the stage for subsequent cardiovascular trouble,” principal investigator Eric Seaberg, PhD, explained in a press release. “We believe our findings are relevant to anyone infected with hepatitis C regardless of HIV status.”

Clinicians should assess the overall cardiac risk profile of these patients regularly, and should also be on the lookout for signs of liver disease, the researchers suggest. This patient population would additionally benefit from annual cardiac examinations, including cholesterol and glucose testing, blood pressure checks, and assessment of lifestyle habits.

The researchers also found that chronic hepatitis C infection and HIV infection were independently linked to the prevalence of any plaque and noncalcified plaque, but there seemed to be no evidence of a synergistic effect due to HIV and hepatitis C coinfection.

The study authors highlighted the fact that treating hepatitis C infection sooner rather than later can prevent long term liver damage. However, it is still unknown whether a new class of medications that are successful for 90 percent of patients would also be able to aid the reduction of cardiac disease in this patient population. Future research should determine whether hepatitis C infection duration or hepatitis C treatment influence coronary plaque development, the authors suggest.