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Abstract

Background

Hepatitis C virus (HCV) coinfection is common among people living with HIV (PLWH) and is associated with adverse outcomes. However, the specific association between HCV coinfection and the risk of acute myocardial infarction (AMI) in PLWH remains unclear. This systematic review and meta-analysis aims to clarify this relationship.

Method

We searched MEDLINE and EMBASE databases from inception to October 2024 for cohort studies comparing the incidence of AMI in PLWH with HCV coinfection versus PLWH without HCV coinfection (HIV mono-infection). We used the generic inverse variance method with a random-effects model to pool risk ratios (RRs) and 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic. All statistical analyses were performed using Review Manager 5.4.

Results

Seven cohort studies, encompassing 94,664 participants (mean age 42 years, 83% male), met the inclusion criteria. HCV coinfection was associated with a significantly increased risk of AMI in PLWH (pooled RR = 1.25, 95% CI: 1.09, 1.44; I² = 18%; p < .001) compared to HIV mono-infection. A subgroup analysis restricted to type 1 AMI was not statistically significant (pooled RR = 1.03, 95% CI: 0.84, 1.26; p = .78).

Conclusions

HCV coinfection is associated with a significantly increased risk of AMI in PLWH. Further research is needed to determine the pathophysiology of this relationship.

Keywords

Hepatitis C acute myocardial infarction HIV systematic review meta-analysis

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References

Akhtar

Fatima

Saeed

, et al. HIV-HCV coinfection: prevalence and treatment outcomes in Malaysia. Intervirology 2021; 65(2): 87–93.

Dodig

Tavill

. Hepatitis C and human immunodeficiency virus coinfections. J Clin Gastroenterol 2001; 33(5): 367–374.

Tran

Saleem

Lim

, et al. Global estimates for the lifetime cost of managing HIV. AIDS 2021; 35(8): 1273–1281.

Tian

Chen

Wang

, et al. Global, regional, and national HIV/AIDS disease burden levels and trends in 1990-2019: a systematic analysis for the global burden of disease 2019 study. Front Public Health 2023; 11: 1068664.

Zhu

Wang

, et al. Higher cardiovascular disease risks in people living with HIV: a systematic review and meta-analysis. J Glob Health 2024; 14: 04078.

Zhao

Wei

Dou

, et al. Changing mortality and patterns of death causes in HIV infected patients - China, 2013-2022. China CDC Wkly 2023; 5(48): 1073–1078.

Williams-Nguyen

Hawes

Nance

, et al. Association between chronic hepatitis C virus infection and myocardial infarction among people living with HIV in the United States. Am J Epidemiol 2020; 189(6): 554–563.

Freiberg

Chang

Skanderson

, et al. The risk of incident coronary heart disease among veterans with and without HIV and hepatitis C. Circ Cardiovasc Qual Outcomes 2011; 4(4): 425–432.

Fernández-Montero

Barreiro

de Mendoza

, et al. Hepatitis C virus coinfection independently increases the risk of cardiovascular disease in HIV-positive patients. J Viral Hepat 2016; 23(1): 47–52.

10.

Bedimo

Westfall

Mugavero

, et al. Hepatitis C virus coinfection and the risk of cardiovascular disease among HIV-infected patients. HIV Med 2010; 11(7): 462–468.

11.

Data Collection on Adverse Events of Anti-HIV Drugs DAD Study Group Weber

Sabin

, et al. HBV or HCV coinfections and risk of myocardial infarction in HIV-infected individuals: the D:A:D Cohort Study. Antivir Ther 2010; 15(8): 1077–1086.

12.

Gillis

Smieja

Cescon

, et al. Risk of cardiovascular disease associated with HCV and HBV coinfection among antiretroviral-treated HIV-infected individuals. Antivir Ther 2014; 19(3): 309–317.

13.

Lang

Humes

Hogan

, et al. Evaluating the cardiovascular risk in an aging population of people with HIV: the impact of hepatitis C virus coinfection. J Am Heart Assoc 2022; 11(19): e026473.

14.

Hartling

Hamm

Milne

, et al. Decision rules for application of the Newcastle-Ottawa Scale. Rockville: Agency for Healthcare Research and Quality, 2012.

15.

DerSimonian

Laird

. Meta-analysis in clinical trials. Control Clin Trials 1986; 7(3): 177–188.

16.

Higgins

Thompson

Deeks

, et al. Measuring inconsistency in meta-analyses. Bmj 2003; 327(7414): 557–560.

17.

Guitton

Montastruc

Lapeyre-Mestre

, et al. Influence of HCV or HBV coinfection on adverse drug reactions to antiretroviral drugs in HIV patients. Eur J Clin Pharmacol 2006; 62(3): 243–249.

18.

Khan

Sulaiman

Soo

, et al. Chronic hepatitis C prevalence and its correlation with CD4 cells and liver enzymes among HIV positive patients: a Malaysian scenario. Value Health 2014; 17(7): A803.

19.

Kildow

Politzer

DiLallo

, et al. Short and long-term postoperative complications following total joint arthroplasty in patients with human immunodeficiency virus, hepatitis B, or hepatitis C. Article. J Arthroplast 2018; 33(7): S86–S92.

20.

Mascolini

MHIV

, HIV, HBV, and HCV in Europe: border crossings and buried tombs. IAPAC European sessions 2005. October 6-7, 2005. Amsterdam, The Netherlands. IAPAC Mon 2005; 11(12):386-390.

21.

Osibogun

Ogunmoroti

Michos

, et al. HIV/HCV co-infection and the risk of cardiovascular disease: a systematic review and meta-analysis. Conference Abstract. Circulation 2017; 24: 135.

22.

Schlabe

Boesecke

van Bremen

, et al. People living with HIV, HCV and HIV/HCV coinfection in intensive care in a German tertiary referral center 2014-2019. Infection 2023; 51(6): 1645–1656.

23.

Sherazi

SAA

Goyal

Tahir

, et al. Cirrhosis in HIV versus non-HIV patients - analysis of demographics, outcomes and healthcare utilization from a national database. Conference Abstract. Hepatology (Baltim, Md) 2021; 74(SUPPL 1): 1207A–1208A.

24.

Widmer

Lerman

. Endothelial dysfunction and cardiovascular disease. Glob Cardiol Sci Pract 2014; 2014(3): 291–308.

25.

Fletcher

Wilson

Murray

, et al. Hepatitis C virus infects the endothelial cells of the blood–brain barrier. Gastroenterology (New York, N Y, 1943) 2012; 142(3): 634–643.

26.

Ivanov

Bartosch

Smirnova

, et al. HCV and oxidative stress in the liver. Viruses 2013; 5(2): 439–469.

27.

Zampino

Marrone

Restivo

, et al. Chronic HCV infection and inflammation: clinical impact on hepatic and extra-hepatic manifestations. World J Hepatol 2013; 5(10): 528–540.

28.

Ishizaka

Takahashi

, et al. Association between hepatitis C virus seropositivity, carotid-artery plaque, and intima-media thickening. Lancet 2002; 359(9301): 133–135.

29.

Bose

Ray

. Hepatitis C virus infection and insulin resistance. World J Diabetes 2014; 5(1): 52–58.

30.

Nou

Grinspoon

. Inflammation, immune activation, and cardiovascular disease in HIV. AIDS 2016; 30(10): 1495–1509.

31.

Alvaro-Meca

Maté-Cano

Ryan

, et al. Epidemiological trend of sepsis in patients with hospital admissions related to hepatitis C in Spain (2000-2015): a nationwide study. J Clin Med 2020; 9(6): 1607.

32.

Rios

Casciato

Caldirola

, et al. Chronic hepatitis C pathogenesis: immune response in the liver microenvironment and peripheral compartment. Front Cell Infect Microbiol 2021; 11: 712105.

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Hepatitis C increases acute myocardial infarction risk in people living with HIV: A systematic review and meta-analysis