Chronic HCV Infection and Cerebrovascular Disease Risk

X-ray image of cerebrovascular disease
Researchers found data that showed chronic hepatitis C virus infection and associated carotid intima-media thickness and plaque are predictors for cerebrovascular disease.

Chronic infection with hepatitis C virus (HCV) may be associated with altered cerebrovascular activity, which may have an unfavorable effect on cerebrovascular hemodynamics and might lead to an increased risk for cerebrovascular disease, according to a cross-sectional observational study published in PLOS One.1

HCV is a major global health problem, causing as many as 350,000 deaths from HCV-related complications.1 Cerebrovascular disease is the second leading cause of death worldwide. HCV infection is associated with systemic inflammation and metabolic complications that might predispose patients to atherosclerosis, including cerebrovascular atherosclerosis; however, this link remains controversial.2-5 Thus, researchers in Croatia assessed cerebrovascular reactivity in 17 patients with chronic HCV infection, as well as in 11 healthy patients in a control group.1 A well-established breath-holding test that uses transcranial color Doppler for measurement of blood flow velocity was used to assess cerebrovascular reactivity. They found that the group with HCV infection had significantly lower average peak systolic (P =.018), end-diastolic (P =.031), and mean velocity values at the very beginning of the breath-holding procedure (P =.02), as well as a lower mean peak systolic velocity at the end of the breath-holding test (P =.02). Vascular reactivity values were also significantly lower (P =.045) in the HCV group.

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“In conclusion, the results of this study suggest an association between chronic HCV infection and altered cerebrovascular reactivity which may ultimately have an unfavorable effect on cerebrovascular hemodynamics and lead to increased risk of cerebrovascular diseases,” stated the authors.1 They added that, “Future studies should also include post-treatment HCV patients in order to assess the impact of antiviral therapy on cerebrovascular reactivity.”

1. Pavicic Ivelja M, Ivic I, Dolic K, Mestrovic A, Perkovic N, Jankovic S. Evaluation of cerebrovascular reactivity in chronic hepatitis C patients using transcranial color doppler. PLoS ONE. 2019;14(6):e0218206.

2. Ishizaka Y, Ishizaka N, Takahashi E, et al. Association between hepatitis C virus core protein and carotid atherosclerosis. Circ J. 2003;67:26-30.

3. Ishizaka N, Ishizaka Y, Takahashi E, et al. Association between hepatitis C virus seropositivity, carotid-artery plaque, and intima-media thickening. Lancet. 2002;359:133-135.

4. Liao C-C, Su T-C, Sung F-C, Chou W-H, Chen T-L. Does hepatitis C virus infection increase risk for stroke? A population-based cohort study. PLoS ONE. 2012;7(2):e31527.

5. Lee MH, Yang HI, Wang CH, et al. Hepatitis C virus infection and increased risk of cerebrovascular disease. Stroke. 2010;41:2894-2900.