December 11, 2011

Carotid atherosclerosis and chronic hepatitis C: A prospective study of risk associations

Hepatology. 2011 Dec 2. doi: 10.1002/hep.25508. [Epub ahead of print]

Petta S, Torres D, Fazio G, Cammà C, Cabibi D, Di Marco V, Licata A, Marchesini G, Mazzola A, Parrinello G, Novo S, Licata G, Craxì A.


Sezione di Gastroenterologia, Di.Bi.M.I.S, Università di Palermo, Italia.


There are contrasting results in studies of cardiovascular risk in patients with genotype 1 chronic hepatitis C (G1 CHC). We evaluated the prevalence of carotid atherosclerosis compared with a control population in order to assess the potential association between atherosclerosis, host and viral factors, and liver histological features.


One hundred seventy-four consecutive biopsy-proven G1 CHC patients were evaluated by anthropometric and metabolic measurements. One hundred seventy-four patients attending an outpatient cardiology unit were used as controls. Intima-media thickness (IMT) and carotid plaques, defined as focal thickening of > 1.3 mm at the level of common carotid, were evaluated using ultrasonography. All G1 CHC biopsies were scored by one pathologist for staging and grading, and graded for steatosis.


Carotid plaques were found in 73 (41.9%) G1 CHC patients compared with 40 (22.9%) control patients (p<0.001). Similarly, G1 CHC patients had a greater IMT compared with control patients (1.04±0.21 versus 0.90±0.16; p<0.001). Multivariate logistic regression analysis showed that older age (OR 1.047, 95%CI 1.014-1.082, p= 0.005), and severe hepatic fibrosis (OR 2.177, 95%CI 1.043-4.542, p=0.03), were independently linked to the presence of carotid plaques. In patients aged ≤55 years, 15/67 cases with F0-F2 fibrosis (22.3%) had carotid plaques, compared with 11/21 (52.3%) with F3-F4 fibrosis (p=0.008). By contrast, in patients >55 years the prevalence of carotid plaques was similar in those with or without severe fibrosis (25/43, 58.1% versus 22/43, 51.1%; p=0.51).


Severe hepatic fibrosis is associated with a high risk of early carotid atherosclerosis in G1 CHC patients. (HEPATOLOGY 2011.).

Copyright © 2011 American Association for the Study of Liver Diseases


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