Thématique :
- Foie
- Hépatites virales
Originalité :
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Professeur Jean-Marie PERON
Coup de coeur :
  2015 Sep. pii: S0016-5085(15)01322-0  
  doi: 10.1053/j.gastro.2015.09.007  
  Hepatitis C Virus Infection is Associated With Increased Cardiovascular Mortality: A Meta-analysis of Observational Studies  
  Petta S, Maida M, Macaluso FS, Barbara M, Licata A, Craxì A, Cammà C  

Background & Aims
There have been many studies of the effects of hepatitis C virus (HCV) infection on cardiovascular risk, but these have produced ambiguous results. We performed a meta-analysis of these studies to systematically assess the risk of HCV infection on cardiovascular disease (CVD)-related morbidity and mortality.

We searched PubMed Central, Medline, Embase, and Cochrane Library, as well as reference lists of articles, for studies published through July 2015 that compared the occurrence of CVD between HCV-infected and uninfected subjects, or assessed the prevalence of HCV infection among subjects with CVDs. In total, 22 studies were analyzed. Data on the patient populations and outcomes were extracted from each study by 3 independent observers and combined by a random-effects model.

Compared to uninfected individuals (controls), HCV-infected patients had increased risks of CVD-related mortality (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.07–2.56; P=.02), carotid plaques (OR, 2.27; 95% CI, 1.76–2.94; P<.001), and cerebro-cardiovascular events (OR, 1.30; 95% CI 1.10–1.55; P=.002). Significant heterogeneity was observed in the risk of cerebrocardiovascular disease among individuals with HCV infection. The effect of HCV infection on cerebrocardiovascular disease was stronger in populations with a higher prevalence of diabetes (>10%) or hypertension (>20%) (OR, 1.71; 95% CI, 1.32–2.23; P<.001 for both).

In a meta-analysis of published studies, individuals with HCV infections were found to be at increased risk for CVD-related morbidity and mortality—especially those with diabetes and hypertension.

Question posée
Influence de l’infection par le VHC sur les risques cardiovasculaires.
Question posée
Augmentation des accidents vasculaires cérébraux, de la plaque carotidienne et de la mortalité liée aux AVC chez les patients infectés par le VHC par rapport aux patients non infectés par le VHC. Surtout chez les patients diabétiques ou hypertendus.

Ne pas oublier le bilan cardiovasculaire chez nos patients VHC +.