Department of Community, Environmental and Occupational Medicine, Ain Shams University, Cairo, Egypt.
National Research Center, Cairo, Egypt.
Trop Med Int Health. 2018 Jul;23(7):738-747. doi: 10.1111/tmi.13068. Epub 2018 May 23.
To examine the association between hepatitis C virus (HCV) infection, cardiovascular risk factors and cerebro-cardiovascular (CCV) disease.
The source of data was the Egypt Health Issues Survey conducted in 2015. Participants were 11 256 individuals with complete HCV testing, age 25-59 years. Data on demographics, cardiovascular risk factors, CCV disease (myocardial infarction and/or cerebral stroke) and HCV infection were retrieved. Descriptive, bivariate, multivariable logistic regression and sensitivity analyses were performed to determine the independent association of past HCV exposure or chronic infection with diabetes, hypertension and CCV disease.
3.9% of participants were antibody positive/RNA negative and considered to have past HCV exposure; 7.9% had detectable HCV-RNA and were considered to have chronic infection. Participants with negative antibodies and no history of liver disease (n = 9928) were the control group. In addition to the previously known risk factors, multivariable analyses revealed that diabetes was independently associated with past HCV exposure (OR = 1.71, 95% CI: 1.27-2.32) and HCV chronic infection (OR = 1.56, 95% CI: 1.23-1.97), whereas CCV disease was independently associated with past exposure (OR = 2.69, 95% CI: 1.62-4.46) and not with chronic infection. No evidence of an association between hypertension and either HCV status was found.
The association of both past HCV exposure and chronic infection with diabetes and that of past HCV exposure with CCV disease may suggest targeting HCV-positive reactors for preventive and curative programmes addressing extrahepatic complications.
探讨丙型肝炎病毒（HCV）感染、心血管危险因素与心脑血管（CCV）疾病的关系。
数据来源于 2015 年进行的埃及健康问题调查。研究对象为 11256 名年龄在 25-59 岁之间、完成 HCV 检测的个体。检索了人口统计学、心血管危险因素、CCV 疾病（心肌梗死和/或脑卒）和 HCV 感染的数据。进行了描述性、双变量、多变量逻辑回归和敏感性分析，以确定过去 HCV 暴露或慢性感染与糖尿病、高血压和 CCV 疾病的独立关联。
3.9%的参与者抗体阳性/RNA 阴性，被认为有过去的 HCV 暴露；7.9%的人有可检测到的 HCV-RNA，被认为患有慢性感染。无抗体且无肝病史的参与者（n=9928）为对照组。除了先前已知的危险因素外，多变量分析显示，糖尿病与过去的 HCV 暴露（OR=1.71，95%CI：1.27-2.32）和 HCV 慢性感染（OR=1.56，95%CI：1.23-1.97）独立相关，而 CCV 疾病与过去的暴露（OR=2.69，95%CI：1.62-4.46）独立相关，与慢性感染无关。未发现高血压与 HCV 状态之间存在关联的证据。
过去的 HCV 暴露和慢性感染与糖尿病以及过去的 HCV 暴露与 CCV 疾病的相关性，可能表明需要针对 HCV 阳性反应者开展预防和治疗计划，以解决肝外并发症问题。
