title: Hepatitis C virus and atherosclerosis: A legacy after virologic cure?
abstract: Hepatitis C virus (HCV) is a major pathogen with approximately 3% of the world's population (over 170 million) infected. Epidemiological studies have shown HCV is associated with an increased risk of cardiovascular and cerebrovascular mortality as well as peripheral arterial disease. This is despite HCV inducing an ostensibly favourable lipid profile with accompanying low classical risk score for atherosclerosis (AS). We discuss possible factors involved in the aetiopathogenesis of atherosclerosis in chronic HCV and hypothesise that an important mechanism underlying the development of AS is the presence of circulating low-density immune complexes that induce an inflammatory response. We suggest that HCV particles may be inducing an antibody response to lipoproteins present in the lipoviral particles and sub-viral particles - a concept similar to the more general 'autoantibody' response to modified LDL. After virologic cure some AS risk factors will recede but an increase in serum cholesterol could result in progression of early atherosclerotic lesions, leaving a legacy from persistent HCV infection that has clinical and therapeutic implications.
authors.affiliation: Institute of Cellular Medicine, Newcastle University, United Kingdom; Department of Hepatology & Gastroenterology, Imperial College London, United Kingdom. Electronic address: m.bassendine@imperial.ac.uk.
authors.forename: M F
authors.initials: MF
authors.lastname: Bassendine
authors.affiliation: Institute of Cellular Medicine, Newcastle University, United Kingdom.
authors.forename: S U
authors.initials: SU
authors.lastname: Nielsen
authors.affiliation: Institute of Cellular Medicine, Newcastle University, United Kingdom; Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom.
authors.forename: S H
authors.initials: SH
authors.lastname: Bridge
authors.affiliation: Institute of Cellular Medicine, Newcastle University, United Kingdom; Institute of Translational and Stratified Medicine, Peninsula Schools of Medicine & Dentistry, Plymouth University, United Kingdom.
authors.forename: D J
authors.initials: DJ
authors.lastname: Felmlee
authors.affiliation: Institute of Cellular Medicine, Newcastle University, United Kingdom; Institute of Translational and Stratified Medicine, Peninsula Schools of Medicine & Dentistry, Plymouth University, United Kingdom.
authors.forename: D A
authors.initials: DA
authors.lastname: Sheridan
authors.affiliation: Institute of Cardiovascular and Medical Sciences, Floor 2, McGregor Building, University of Glasgow, United Kingdom.
authors.forename: C J
authors.initials: CJ
authors.lastname: Packard
authors.affiliation: Department of Clinical Biochemistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom.
authors.forename: R D
authors.initials: RD
authors.lastname: Neely
mesh_terms: D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D003324:Coronary Artery Disease / Q000175:diagnosis; D018450:Disease Progression; D016174:Hepacivirus / Q000302:isolation & purification / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D019562:Viral Load