Hepatitis C virus infection increases the risk of developing peripheral arterial disease: a 9-year population-based cohort study

Yueh-Han Hsu; Chih-Hsin Muo; Chun-Yi Liu; Wen-Chen Tsai; Chih-Cheng Hsu; Fung-Chang Sung; Chia-Hung Kao

doi:10.1016/j.jhep.2014.09.022

Hepatitis C virus infection increases the risk of developing peripheral arterial disease: a 9-year population-based cohort study

J Hepatol. 2015 Mar;62(3):519-25. doi: 10.1016/j.jhep.2014.09.022. Epub 2014 Sep 28.

Authors

Yueh-Han Hsu¹, Chih-Hsin Muo², Chun-Yi Liu³, Wen-Chen Tsai³, Chih-Cheng Hsu⁴, Fung-Chang Sung⁵, Chia-Hung Kao⁶

Affiliations

¹ Department of Public Health, China Medical University, Taichung City 404, Taiwan; Department of Health Services Administration, China Medical University, Taichung City 404, Taiwan; Department of Internal Medicine, Division of Nephrology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan; Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan City 736, Taiwan.
² Management Office for Health Data, China Medical University Hospital, Taichung City 404, Taiwan; School of Medicine, China Medical University, Taichung City 404, Taiwan.
³ Department of Public Health, China Medical University, Taichung City 404, Taiwan; Department of Health Services Administration, China Medical University, Taichung City 404, Taiwan.
⁴ Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County 35053, Taiwan; Department of Health Services Administration, China Medical University and Hospital, Taichung City 404, Taiwan.
⁵ Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung City 404, Taiwan.
⁶ Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung City 404, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung City 404, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

PMID: 25263004
DOI: 10.1016/j.jhep.2014.09.022

Abstract

Background & aims: The relationship between hepatitis C virus (HCV) infection and peripheral arterial disease (PAD) development remains unclear.

Methods: Health insurance claims data were used to construct a cohort of HCV-infected patients diagnosed during the period 1998-2011. Patients younger than 20 years and those with history of hepatitis B or PAD were excluded. We selected 7641 HCV-infected patients and 30564 matched controls. The adjusted risk of developing PAD was analyzed using a multivariate Cox hazard model.

Results: The results show that the excess risk of PAD development in HCV-infected patients is 1.43-fold higher (95% CI=1.23-1.67) compared with non-HCV patients. The adjusted risk of PAD development increases with age; compared with the 20-34 year-old patients, the risk is 3.96-fold higher in HCV-infected patients aged 35-49 years, and 11.7-fold higher in those aged 65 years and above. CKD/ESRD has the highest risk for PAD (HR=1.80, 95% CI=1.29-2.53). HCV-infected patients with four comorbidities exhibit a substantially higher risk of developing PAD (HR=9.25, 95% CI=6.35-13.5). Excess risk of developing PAD is observed from the first year of follow-up till the third year.

Conclusion: HCV-infected patients have an independently higher risk of developing PAD. HCV-infected patients with comorbidity have increased risk of developing PAD.

Keywords: Cardiovascular disease; Chronic kidney disease; Comorbidity; Hepatitis; Peripheral arterial disease; Stroke.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Case-Control Studies
Cohort Studies
Comorbidity
Female
Hepatitis C / complications*
Hepatitis C / epidemiology
Humans
Male
Middle Aged
Peripheral Arterial Disease / epidemiology
Peripheral Arterial Disease / etiology*
Proportional Hazards Models
Retrospective Studies
Risk Factors
Taiwan / epidemiology
Young Adult