Format

Send to

Choose Destination
World J Gastroenterol. 2014 Apr 7;20(13):3410-7. doi: 10.3748/wjg.v20.i13.3410.

Chronic hepatitis C virus infection and atherosclerosis: clinical impact and mechanisms.

Author information

1
Luigi E Adinolfi, Rosa Zampino, Luciano Restivo, Barbara Guerrera, Aldo Marrone, Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, 80100 Naples, Italy.

Abstract

Hepatitis C virus (HCV) infection represents a major health issue worldwide due to its burden of chronic liver disease and extrahepatic manifestations including cardiovascular diseases, which are associated with excess mortality. Analysis of published studies supports the view that HCV infection should be considered a risk factor for the development of carotid atherosclerosis, heart failure and stroke. In contrast, findings from studies addressing coronary artery disease and HCV have yielded conflicting results. Therefore, meta-analytic reviews and prospective studies are warranted. The pathogenic mechanisms connecting HCV infection, chronic liver disease, and atherogenesis are not completely understood. However, it has been hypothesized that HCV may promote atherogenesis and its complications through several direct and indirect biological mechanisms involving HCV colonization and replication within arterial walls, liver steatosis and fibrosis, enhanced and imbalanced secretion of inflammatory cytokines, oxidative stress, endotoxemia, mixed cryoglobulinemia, perturbed cellular and humoral immunity, hyperhomocysteinemia, hypo-adiponectinaemia, insulin resistance, type 2 diabetes and other components of the metabolic syndrome. Understanding these complex mechanisms is of fundamental importance for the development of novel therapeutic approaches to prevent and to treat vascular complications in patients with chronic HCV infection. Currently, it seems that HCV clearance by interferon and ribavirin treatment significantly reduces non-liver-related mortality; moreover, interferon-based treatment appears to decrease the risk of ischemic stroke.

KEYWORDS:

Atherosclerosis; Coronary artery disease; Hepatitis C virus; Inflammation; Stroke

PMID:
24707124
PMCID:
PMC3974508
DOI:
10.3748/wjg.v20.i13.3410
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Baishideng Publishing Group Inc. Icon for PubMed Central
Loading ...
Support Center