Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 08 / 16 / 2018

Welcome to JCTH

Cardiovascular Involvement in Chronic Hepatitis C Virus Infections – Insight from Novel Antiviral Therapies

REVIEW ARTICLE

Cardiovascular Involvement in Chronic Hepatitis C Virus Infections – Insight from Novel Antiviral Therapies

Wolfgang Poller*1,2, Arash Haghikia1,2, Mario Kasner1, Ziya Kaya3,4, Udo Bavendiek5, Heiner Wedemeier6, Hans-Jörg Epple7, Carsten Skurk1 and Ulf Landmesser1,2

1Department of Cardiology, CC11 Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
2German Center for Cardiovascular Research (DZHK) Site Berlin, Berlin, Germany
3German Center for Cardiovascular Research (DZHK) Site Heidelberg, Heidelberg, Germany
4Department of Cardiology, University Hospital, Heidelberg, Germany
5Department of Cardiology, MHH, Hannover, Germany
6Department of Gastroenterology, MHH, Hannover, Germany
7Department of Gastroenterology, Infectiology and Rheumatology, CC 13, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany

*Correspondence to: Wolfgang Poller, Department of Cardiology, Campus Benjamin Franklin, Charite Centrum 11, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin 12200, Germany. Tel: +49-30-450-513765, Fax: +49-30-450-513984, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(2):161-167 DOI: 10.14218/JCTH.2017.00057
Received: August 22, 2017 Accepted: December 23, 2017 Published online: January 26, 2018

Abstract

Whereas statistical association of hepatitis C virus (HCV) infection with cardiomyopathy is long known, establishment of a causal relationship has not been achieved so far. Patients with advanced heart failure (HF) are mostly unable to tolerate interferon (IFN)-based treatment, resulting in limited experience regarding the possible pathogenic role of HCV in this patient group. HCV infection often triggers disease in a broad spectrum of extrahepatic organs, with innate immune and autoimmune pathogenic processes involved. The fact that worldwide more than 70 million patients are chronically infected with HCV illustrates the possible clinical impact arising if cardiomyopathies were induced or aggravated by HCV, resulting in progressive HF or severe arrhythmias. A novel path has been opened to finally resolve the long-standing question of cause-effect relationship between HCV infection and cardiac dysfunction, by the recent development of IFN-free, highly efficient, and well tolerable anti-HCV regimens. The new direct-acting antiviral (DAA) agents are highly virus-specific and lack unspecific side-effects upon cardiac function which have always confounded the interpretation of IFN treatment data. The actual frequency of unexplained HF in chronic HCV infection will be determined from a planned large-scale study. Whereas such patients probably constitute a rather small fraction of all those harboring HCV, they have major clinical relevance. It is not yet known which fraction of these patients will significantly benefit from HCV eradication, but this issue will be addressed now in a prospective study.

Keywords

Autoimmunity, Cardiovascular immunity, Cardiomyopathies, Hepatitis C virus, Antiviral therapies

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 161-167  [ Html ] [ PDF Full-text ]

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

 logo

You are here: Home Vol 6 Issue 2 Cardiovascular Involvement in Chronic Hepatitis C Virus Infections – Insight from Novel Antiviral Therapies