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Carotid plaque may be associated with hepatic fibrosis

Patients with chronic hepatitis C and severe hepatic fibrosis may be more likely to have carotid atherosclerosis, according to recent results.

Researchers evaluated 174 patients with biopsy-proven genotype 1 chronic hepatitis C (G1 CHC) along with a 174-person control group. Ultrasonography was used to measure intima-media thickness (IMT) and carotid plaques, and biopsy results were scored according to staging and grading, as well as for steatosis.

Among the G1 CHC patients, 41.9% had carotid plaques, compared with 22.9% of the control group (P<.001). Advanced age (OR=1.047; 95% CI, 1.014-1.082) and severe hepatic fibrosis (OR=2.177; 95% CI, 1.043-4.542) were independently associated with carotid plaques through multivariate analysis.

G1 CHC patients also had a greater degree of IMT (1.04 ± 0.21) compared with the controls (0.90 ± 0.16) (P<.001). Multivariate analysis indicated that low platelet count (P=.04) and arterial hypertension (P=.01) were independently associated with elevated IMT. Investigators did not find an association between steatosis and carotid plaques.

Patients aged 55 years or younger with F0-F2 fibrosis had significantly fewer instances of carotid plaques than patients with F3-F4 fibrosis (22.3% vs. 52.3%, P=.008). Among patients aged 56 years and older, the incidence of carotid plaque was similar regardless of hepatic fibrosis or not (58.1% vs. 51.1%, P=.51). The mean age of participants was 53 years (range 23-75 years).

“The presence of advanced hepatic fibrosis identifies a subgroup of G1 CHC patients at higher risk of atherosclerotic lesions who should be carefully monitored in liver units, independently of their metabolic profile,” the researchers concluded.