title: Hepatitis C as a risk factor for carotid atherosclerosis - a systematic review.
abstract: BACKGROUND
  Observational studies on the association of chronic hepatitis C with carotid atherosclerosis have yielded varying results. In addition, previous related systematic reviews were limited in synthesis. By more careful selection and further synthesis, we summarize current body of evidence on the relationship between chronic hepatitis C and carotid atherosclerosis.
  
  
  METHODS
  All published observational studies related to the topic identified by systematic searches of PubMed and Scopus were screened based on diagnosis of chronic hepatitis C and diagnosis and estimation of the risk of a carotid atherosclerosis-related outcome. Selected studies were subjected to quality assessment, and eligible studies were used in subsequent narrative and quantitative syntheses.
  
  
  RESULTS
  The initial search identified 190 unique publications, which were narrowed by preliminary review to 16 potentially relevant original articles. After quality assessment, seven studies were eligible and were used in narrative synthesis. Five studies assessed the risk of increased carotid intimal media thickening using B mode ultrasonography; five studies assessed the risk of carotid plaque formation using B mode ultrasonography. Five of these studies were used in subsequent meta-analysis. The risk of a person with chronic hepatitis C developing carotid intimal media thickening is about 4·03 times the risk of an uninfected person. The risk of a person with chronic hepatitis C developing carotid plaque is about 3·94 times the risk of an uninfected person.
  
  
  CONCLUSIONS
  Current evidence shows that hepatitis C virus (HCV) or factors associated with HCV infection can promote the occurrence and progression of carotid atherosclerosis.
authors.affiliation: Department of Public Health, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Olubunmi O
authors.initials: OO
authors.lastname: Olubamwo
authors.affiliation: Department of Public Health, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ifeoma N
authors.initials: IN
authors.lastname: Onyeka
authors.affiliation: Department of Public Health, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Miettola
authors.affiliation: Department of Public Health, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Kauhanen
authors.affiliation: Department of Public Health, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Tomi-Pekka
authors.initials: TP
authors.lastname: Tuomainen
mesh_terms: D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000821:virology*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D064887:Observational Studies as Topic; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
keywords: cardiovascular; chronic; hepatitis C virus; inflammation; meta-analysis