Is hepatitis C associated with atherosclerotic burden? A systematic review and meta-analysis

He Huang, Rongyan Kang, Zhendong Zhao, He Huang, Rongyan Kang, Zhendong Zhao

Abstract

Background and aims: Increasing evidence demonstrates that hepatitis C virus (HCV) infection is associated with atherosclerosis. However, there are contrasting findings in several studies that the atherosclerotic burden is not associated with HCV infections. Therefore, we performed a meta-analysis to clarify if HCV infection is associated with atherosclerosis compared to non-infected people.

Methods: Standard guidelines for performance of meta-analysis were followed.

Results: A thorough database search performed by two independent investigators identified 14 eligible studies for analysis. The data from 11 studies were synthesized to report unadjusted odds ratios (ORs) for carotid atherosclerosis; the pooled unadjusted OR (95% confidence interval (CI)) was 1.65 (1.21, 2.09). By synthesizing the data from 8 studies to report adjusted ORs for carotid atherosclerosis the pooled multi-confounder adjusted OR (95% CI) was 1.76 (1.20, 2.32). However, the numbers of studies on coronary or femoral atherosclerosis were limited and not enough for analysis.

Conclusions: Our meta-analysis indicates that HCV infection is associated with carotid atherosclerosis independent of classical risk factors. Therefore, we would recommend for HCV infected patients to be counseled on their risk for carotid atherosclerosis.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flow diagram of study identification.
Figure 1. Flow diagram of study identification.
Figure 2. Forest plot for meta-analysis comparing…
Figure 2. Forest plot for meta-analysis comparing unadjusted OR of carotid atherosclerosis in HCV infected patients compared to that in non-infected controls.
Unadjusted ORs from included studies and the pooled OR are shown. Dimension of shaded OR for individual studies is proportional to their total weight in calculation of the pooled estimator.
Figure 3. Forest plot for meta-analysis comparing…
Figure 3. Forest plot for meta-analysis comparing adjusted OR of carotid atherosclerosis in HCV infected patients compared to that in non-infected controls.
Eight studies reporting unadjusted ORs were included. Unadjusted ORs from the included studies and the pooled OR are shown. Dimension of shaded OR for individual studies is proportional to their total weight in calculation of the pooled estimator.

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