title: Hepatitis C infection and clearance: impact on atherosclerosis and cardiometabolic risk factors.
abstract: BACKGROUND
  Chronic hepatitis C (HCV) infection is associated with diabetes and favourable lipids.
  
  
  OBJECTIVE
  To study the effect of this paradox on atherosclerosis and cardiometabolic response to HCV clearance.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Egypt.
  
  
  METHODS
  329 chronically infected, 173 with cleared infection and 795 never infected participants aged >or=35 attended for baseline investigations. A subsample of 192, 115 and 187, respectively, underwent ultrasound.
  
  
  METHODS
  Diabetes, fasting glucose, lipids and fat deposition on ultrasound. Carotid intima-media thickness (IMT) measured atherosclerosis.
  
  
  RESULTS
  Diabetes prevalence was raised (10.1% (95% CI 6.6 to 13.6), p=0.04) in HCV chronic, and cleared (10.1% (5.6 to 14.8), p=0.08) individuals versus 6.6% (4.9 to 8.3) in those never infected. Mesenteric fat was raised in chronic (36.4 mm (34.5 to 38.2), p=0.004), and cleared infection (37.8 (35.6 to 40.0), p<0.0001) vs never infected (32.7 (31.0 to 34.4)). LDL cholesterol was lower in chronic (2.69 mmol/l (2.53 to 2.86), p<0.001), but similar in cleared (3.56 (3.34 to 3.78), p=0.4) versus never infected (3.45 (3.30 to 3.60)). Carotid IMT did not differ by infection status: 0.73 (0.70 to 0.76, p=0.4), 0.71 (0.66 to 0.75, p=0.9), 0.71 (0.68 to 0.74), respectively. Adjustment for cardiovascular risk factors increased IMT in chronic infection (0.76 (0.72 to 0.79), p=0.02) versus never infected individuals (0.70 (0.67 to 0.73)).
  
  
  CONCLUSIONS
  Hepatic function normalisation with HCV clearance may account for reversal of favourable lipids observed with HCV infection. Hyperglycaemia and visceral adiposity appear less amenable to HCV resolution. These different cardiovascular risk patterns may determine equivalent atherosclerosis risk by infection status. However, once these factors were accounted for, those with chronic infection had raised IMT, suggesting a direct effect of infection.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, AinShams University, Cairo, Egypt.
authors.forename: Aya
authors.initials: A
authors.lastname: Mostafa
authors.forename: Mostafa K
authors.initials: MK
authors.lastname: Mohamed
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saeed
authors.forename: Abubakr
authors.initials: A
authors.lastname: Hasan
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
authors.forename: Ian
authors.initials: I
authors.lastname: Godsland
authors.forename: Emma
authors.initials: E
authors.lastname: Coady
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
authors.forename: Mostafa
authors.initials: M
authors.lastname: El-Hoseiny
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdul-Hamid
authors.forename: Alun
authors.initials: A
authors.lastname: Hughes
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D050197:Atherosclerosis / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D001786:Blood Glucose / Q000378:metabolism; D017536:Carotid Artery, Common / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000821:virology*; D004534:Egypt / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000821:virology; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
chemical_list: D001786:Blood Glucose; D008055:Lipids