This article is more than 5 years old. Information may no longer be current.

HCV may Increase Risk for Coronary Atherosclerosis in MSM

In an analysis of men who have sex with men from the Multicenter AIDS Cohort Study, researchers found that chronic hepatitis C virus infection increased the risk for coronary atherosclerosis, according to published findings.

Researchers, including Rebeccah A. McKibben, MD, MPH, department of medicine, Johns Hopkins University, evaluated 994 men who have sex with men (MSM), both with HIV and without HIV and without heart disease, for coronary plaque using non-contrast coronary CT and coronary CT angiography (CCTA). The goal was to determine if chronic HCV was associated with prevalence and extent of subclinical coronary atherosclerosis among patients with and without HIV. Of these patients, 613 had HIV, 70 were coinfected and 17 had only HCV, according to a press release.

Rebeccah A. McKibben

Men with chronic HCV had a higher prevalence of any plaque shown on CCTA (P = .02) and non-calcified plaque (P < .01) compared with the men without chronic HCV. Chronic HCV was associated with an increased prevalence of coronary artery calcium (CAC; prevalence ratio = 1.29; 95% CI, 1.02-1.63), as well as an increased prevalence of non-calcified plaque (1.42; 95% CI, 1.16-1.75) and any plaque (1.26; 95% CI, 1.09-1.45). HIV was independently and positively associated with a prevalence of any plaque and non-calcified plaque only.

“We have strong reason to believe that infection with hepatitis C fuels cardiovascular disease, independent of HIV and sets the stage for subsequent cardiovascular trouble,” Eric Seaberg, PhD, assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said in the release. “We believe our findings are relevant to anyone infected with hepatitis C regardless of HIV status.”

The prevalence of CAC, any, noncalcified, mixed and calcified plaque was greater among MSM with HCV RNA serum levels of at least two times greater than 10⁶ IU/mL compared to MSM without chronic HCV. In addition, patients with HCV were 50% more likely to have clogged arteries compared with men without hepatitis C. According to the release, high virus levels detected in the blood indicate that the infection is not “well-controlled by drugs or the immune system.”

Further analyses showed that chronic HCV and HIV were independently associated with the prevalence of any and non-calcified plaque. However, the researchers did not observe a synergistic effect due to HIV/HCV coinfection.

“People infected with hepatitis C are already followed regularly for signs of liver disease, but our findings suggest clinicians who care for them should also assess their overall cardiac risk profile regularly,” Wendy Post, MD, MS, professor of medicine at the Johns Hopkins University School of Medicine and a cardiologist at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, said in the release.

The researchers concluded: “Chronic HCV infection is associated with subclinical cardiovascular disease, suggesting that HCV-infected individuals warrant vigilant cardiovascular risk assessments. Future research should determine whether HCV infection duration or HCV treatment impact coronary plaque development.” – by Melinda Stevens

Disclosures: McKibben, Seaberg and Post report no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.