HBV Infection May Not Be Associated With Increased Risk for Coronary Heart Disease

Coronary angiography
Coronary angiography
Researchers conducted the first systematic review and meta-analysis to assess the relationship between HBV and the risk for coronary heart disease.

Hepatitis B virus (HBV) infection may not be associated with an increased risk for coronary heart disease, according to a study published in the International Journal of Cardiology.1

HBV infection is a global health burden, as is coronary heart disease, and while few studies have evaluated the effect HBV has on coronary heart disease, their relationship remains controversial.1 Previous studies have demonstrated that hepatitis C virus infection increases the risk for cardiovascular disease;2,3 therefore, researchers conducted the first systematic review and meta-analysis to assess the relationship between HBV and the risk for coronary heart disease using relevant studies published before October 2017 identified through PubMed, EMBASE, and the ISI Web of Science.1

They found 9 relevant articles, which included 65,058 patients infected with HBV and 534,998 uninfected controls. They did not find an association between HBV infection and the risk for coronary heart disease (relative risk, 0.99; 9% CI, 0.76-1.22).

Similar results were observed in cohort and case-control studies, as well as in subgroup and sensitivity analyses. There was also no evidence of publication bias.

There were several limitations to this study, including potential outcome misclassification, which may limit the comparability of the studies and influence the effect on risk and heterogeneity in the meta-analysis.

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The investigators concluded that, “Available evidence from observational studies indicates that HBV infection does not increase the risk of coronary heart disease. However, as the number of studies of HBV infection and coronary heart disease risk is quite limited, more large prospective studies investigating this relationship are needed.”1


  1. Wang Y, Xiong J, Niu M, Xu W, Xu K, Zhong H. Hepatitis B virus and the risk of coronary heart disease: A comprehensive systematic review and meta-analyses of observational studies [published online April 14, 2018]. Int J Cardiol. doi:10.1016/j.ijcard.2018.04.059
  2. Ambrosino P, Lupoli R, Di Minno A, et al. The risk of coronary artery disease and cerebrovascular disease in patients with hepatitis C: a systematic review and meta-analysis. Int J Cardiol. 2016;221:746-754.
  3. Petta S, Maida M, Macaluso FS, et al. Hepatitis C virus infection is associated with increased cardiovascular mortality: a meta-analysis of observational studies.  Gastroenterology. 2016;150:145-155.