title: Carotid atherosclerosis and chronic hepatitis C: a prospective study of risk associations.
abstract: 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. In all, 174 consecutive biopsy-proven G1 CHC patients were evaluated by anthropometric and metabolic measurements and 174 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 (odds ratio [OR] 1.047, 95% confidence interval [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 ≤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).
  
  
  CONCLUSIONS
  Severe hepatic fibrosis is associated with a high risk of early carotid atherosclerosis in G1 CHC patients.
authors.affiliation: Sezione di Gastroenterologia, Di.Bi.M.I.S, Università di Palermo, Italia. petsa@inwind.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Petta
authors.forename: Daniele
authors.initials: D
authors.lastname: Torres
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fazio
authors.forename: Calogero
authors.initials: C
authors.lastname: Cammà
authors.forename: Daniela
authors.initials: D
authors.lastname: Cabibi
authors.forename: Vito
authors.initials: V
authors.lastname: Di Marco
authors.forename: Anna
authors.initials: A
authors.lastname: Licata
authors.forename: Giulio
authors.initials: G
authors.lastname: Marchesini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mazzola
authors.forename: Gaspare
authors.initials: G
authors.lastname: Parrinello
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Licata
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxì
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D018608:Ultrasonography, Doppler; D055815:Young Adult