October 27, 2010

Hepatitis C increased risks for cerebrovascular-related death

Posted on October 27, 2010

Lee M. Stroke. 2010;doi:10.1161/STROKEAHA.110.598136.

Hepatitis C virus infection was an independent risk predictor of cerebrovascular deaths, indicating a biological gradient of cerebrovascular mortality with increasing serum hepatitis C virus RNA levels, researchers said.

The study included residents (n=23,665, aged 30 to 65 years) from a community-based prospective cohort who were enrolled from 1991 to 1992. Residents answered structured questionnaires and provided blood samples for various serological and biochemical tests at study entry. Researchers tested serum hepatitis C virus (HCV) RNA level and HCV genotype for participants seropositive for antibodies against HCV (anti-HCV).

During the 382,011 person-years of follow-up, researchers reported 255 cerebrovascular deaths, which translated into a cumulative risk for cerebrovascular deaths of 1% for seronegatives and 2.7% for seropositives of anti-HCV (P<.001). The corresponding multivariate-adjusted HR for cerebrovascular death was 2.18 (95% CI, 1.50-3.16) for anti-HCV seropositives.

In additional analysis, compared with patients seronegative for anti-HCV, the multivariate-adjusted HR for anti-HCV-seropositive participants with undetectable serum levels of HCV RNA was 1.40 (95% CI, 0.62-3.16), 2.36 (95% CI, 1.42-3.93) for low serum levels and 2.82 (95% CI, 1.25-6.37) for high serum levels (P<.001 for trend).

“HCV infection is associated with an increased risk of cerebrovascular mortality, particularly for those with elevated serum HCV RNA levels,” the researchers concluded. “If future additional studies confirm the role of HCV infection and the development of cerebrovascular disease, it may be possible to prevent cerebrovascular disease by using specific antiviral strategies.”

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