Journal Article

Hepatitis C Virus Infection and the Risk of Coronary Disease

Butt, Adeel A., Budoff, Matthew, Kuller, Lewis H., Leaf, David, Justice, Amy C., Xiaoqiang, Wang

2009

Overview

Background.The association between hepatitis C virus (HCV) infection and coronary artery disease (CAD) is controversial. We conducted this study to determine and quantify this association. Methods.We used an established, national, observational cohort of all HCV-infected veterans receiving care at all Veterans Affairs facilities, the Electronically Retrieved Cohort of HCV Infected Veterans, to identify HCV-infected subjects and HCV-uninfected control subjects. We used the Cox proportional-hazards model to determine the risk of CAD among HCV-infected subjects and control subjects. Results.We identified 82,083 HCV-infected and 89,582 HCV-uninfected subjects. HCV-infected subjects were less likely to have hypertension, hyperlipidemia, and diabetes but were more likely to abuse alcohol and drugs and to have renal failure and anemia. HCV-infected subjects had lower mean (± standard deviation) total plasma cholesterol (175 ± 40.8 mg/dL vs. 198 ± 41.0 mg/dL), low-density lipoprotein cholesterol (102 ± 36.8 mg/dL vs. 119 ± 38.2 mg/dL), and triglyceride (144 ± 119 mg/dL vs. 179 ± 151 mg/dL) levels, compared with HCV-uninfected subjects (P<.001 for all comparisons). In multivariable analysis, HCV infection was associated with a higher risk of CAD (hazard ratio, 1.25; 95% confidence interval, 1.20-1.30). Traditional risk factors (age, hypertension, chronic obstructive pulmonary disease, diabetes, and hyperlipidemia) were associated with a higher risk of CAD in both groups, whereas minority race and female sex were associated with a lower risk of CAD. Conclusions.HCV-infected persons are younger and have lower lipid levels and a lower prevalence of hypertension. Despite a favorable risk profile, HCV infection is associated with a higher risk of CAD after adjustment for traditional risk factors.

• Publisher: The University of Chicago Press,University of Chicago Press,Oxford University Press
• Subject: Adult / Articles and Commentaries / Atherosclerosis / Biological and medical sciences / Cardiology. Vascular system / Cardiovascular disease / Cholesterol / Chronic obstructive pulmonary disease / Computer aided design / Coronary artery disease / Coronary Disease - epidemiology / Coronary heart disease / Diabetes / Female / Heart / Hepacivirus / Hepatitis / Hepatitis C / Hepatitis C - complications / Hepatitis C virus / Human viral diseases / Humans / Hypertension / Infections / Infectious diseases / Inflammation / Lipids / Male / Medical sciences / Middle Aged / Multivariate analysis / Predisposing factors / Risk Assessment / Risk Factors / Studies / Veterans / Viral diseases / Viral hepatitis