PIN5 - Risk of Cardiovascular Disease Among Patients with Hepatitis C Virus (HCV) Infection

Abstract

The objective of the present study was to describe the profiles of cardiometabolic risk markers in subjects with and without HCV infection and to estimate 10-year risk of CVD in both groups. We examined participants in the Canadian Health Measures Survey (2007-2015) aged 30 years or older for the 10-year risk of developing CVD estimated by the Framingham Risk Score (FRS). We matched 111 HCV-positive cases to 333 HCV-negative controls on age, gender, ethnicity and smoking status. Available cardiometabolic factors included specific markers for obesity, cholesterols and inflammatory markers. Associations with these markers estimated among HCV cases and controls using partial correlation models adjusted for residual confounding. Ten-year CVD risk was estimated for each group. Ten-year CVD risk was significantly associated with obesity, HbA1C, the number of metabolic syndrome markers and homocysteine. Male HCV subjects, but not females, had higher levels of triglycerides (1.21±0.06 vs. 1.51±0.18 mmol/L, p=0.049) and fibrinogen (0.58±0.13 vs 0.95±0.26 mmol/L, p=0.010) compared to controls. In HCV patients, 10-year risk of CVD was associated with increased triglycerides (p=0.017) and fibrinogen (p=0.05). Average 10-year CVD risk was similar among cases (11±0.8%) and controls (12±0.5%) as measured by FRS. The results of the present study support the need to further explore the relationship between HCV infection and risk of CVD. Specific associations between markers for CVD risk were stronger among those with HCV infection compared to those without. HCV infection may lead to increased CVD risk by influencing inflammation and components of the metabolic syndrome. This may lead to an abnormal glucose and lipid metabolism that can be directly associated with atherosclerosis development and increased risk of CVD. The introduction of antiviral agents to treat HCV infection may also contribute to reduced CVD morbidity and mortality in patients with chronic HCV infection.