Is HCV Infection a Risk Factor for Cardiac Complications in TM?

Hepatitis C virus (HCV) infection is associated with a number of important extrahepatic manifestations. The aim of this multicentric study was to assess the relationship between HCV infection and some traditional cardiovascular risk factors (CRF) and its predictive value and cardiovascular complications (CC) in thalassemia major (TM) patients.

We considered 827 TM patients (435 F) consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) network.

At the baseline assessment mean age of the patients, all free of CC, was 29.65±8.89 years and a categorization in 4 groups was performed: negative patients (group 0), patients who spontaneously cleared HCV (group 1), patients who eradicated the virus after treatment with antiviral therapy attaining a sustained virological response-SVR (group 2), and patients with chronic HCV infection (group 3). Patients in group 0 were significantly younger than patients in all the other three groups (P<0.0001) and had a significant lower frequency of diabetes than patients in group 3 (3.6% vs 11.0%; P=0.006).

Patients were followed-up for 79.53±28.71 months and 84 cardiovascular events (42 arrhythmias, 29 heart failure, and 13 vascular diseases) were registered. Table 1 shows the results of the univariate Cox regression analysis. Patients with chronic HCV infection had a significant higher risk of developing CC than negative patients.

In conclusion, HCV chronic infection is associated with a significant higher risk of CC in TM patients and, as a consequence, it should be analyzed as a systemic disease in which extrahepatic consequences increase the weight of its pathological burden.

Table 1

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Table 1

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