الفهرس 
Hepatitis C Virus InfectionOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Chronic hepatitis C (HCV) infection is associated with diabetes yet favorable lipids as regards cardiovascular disease risk. Objective: To study the effect of this paradox on atherosclerosis and metabolic syndrome. Subjects and Methods: Community-based cross-sectional study in a village in Menoufia Governorate, Egypt. Subjects 35 years or older were invited to participate. Interview-based questionnaire, anthropometric and blood pressure measurements, and blood withdrawal for baseline investigations were done. Participants were divided into: 377 chronically infected, 190 cleared infection and 912 never infected with HCV. A subsample underwent ultrasound for abdominal fat distribution and Doppler for carotid intima-media thickness (IMT) as a measure for atherosclerosis. Results: Diabetes prevalence was raised (10.1%, p=0.025), in chronic, and cleared (10.1%, p=0.050) versus 6.9% in those never infected. Mean LDL cholesterol level was lower in chronic (101.3 mg/dl, p<0.0001), but similar in cleared (127.4 mg/dl, p=0.584) and never infected (129.7 mg/dl). Mesenteric fat was raised in chronic (36.2 mm, p=0.011) and cleared infection (38.2, p<0.0001) versus never infected (33.2 mm). After adjustment for cardiovascular risk factors mean IMT increased in chronic infection (0.76 mm, p=0.02) versus never infected individuals (0.7 mm). Conclusions: HCV clearance may account for reversal of favorable lipids observed with chronic HCV infection. Hyperglycemia and visceral adiposity and hence metabolic syndrome appear less amenable to HCV resolution. These different cardiovascular risk patterns may determine equivalent atherosclerosis risk by infection status. However, once these factors were accounted for, those with chronic infection had raised IMT, suggesting a direct effect of infection.