By Liz Highleyman

Studies to date have produced conflicting data about the association between hepatitis C virus (HCV) infection and coronary artery disease, a condition that can lead to heart attacks and strokes.

Researchers presented further evidence at the 48th International Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2008), taking place this week in Washington, DC.

The investigators used the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES), a national observational cohort of all veterans with HCV receiving care at Veterans Affairs facilities, to determine the relationship between HCV infection and risk of incident (newly emerging) coronary artery disease. A total of 82,083 HCV positive veterans were compared with 89,582 HCV negative control subjects.

Results

• Patients with HCV were less likely to have hypertension (high blood pressure), elevated blood lipids, and diabetes than HCV-uninfected individuals.

• However, the HCV positive patients were more likely to smoke cigarettes, more prone to abuse alcohol or drugs, and more likely to experience kidney failure and anemia.

• Compared with HCV-uninfected participants, patients with HCV had lower mean plasma total cholesterol (175 vs 198 mg/dL), low-density lipoprotein (LDL or "bad") cholesterol (102 vs 119 mg/dL), and triglycerides (144 vs 179 mg/dL).

• In a multivariable analysis, HCV infection was associated with a 25% higher risk of coronary artery disease (hazard ratio 1.25; P < 0.001).

• Traditional risk factors (older age, hypertension, smoking, diabetes, elevated lipids) were associated with a higher risk of coronary artery disease.

• Non-white race/ethnicity and female sex were associated with a lower risk.

Based on these findings, the investigators concluded that "HCV-infected persons have lower lipid levels and a lower prevalence of several cardiovascular disease risk factors."

But despite a favorable risk profile, they added, "HCV is associated with a higher risk of coronary artery disease after adjusting for traditional risk factors."

Univ. of Pittsburgh, Pittsburgh, PA; Los Angeles BioMed. Res. Inst., Los Angeles, CA; VA Greater Los Angeles Healthcare System, Los Angeles, CA; Univ. of Pittsburgh Graduate Sch. of Publ. Hlth., Pittsburgh, PA; Yale Univ. Sch. of Med., New Haven, CT.

10/28/08

Reference
AA Butt, W Xiaoqiang, M Budoff, and others. Hepatitis C Virus Infection and the Risk of Coronary Disease. 48th International Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2008). Washington, DC. October 25-28, 2008. Abstract V-4219.