Diagnosis and treatment of HCV heart diseases

ABSTRACT

Introduction

Hepatitis C virus (HCV) infection is an important cause of a variety of otherwise unexplained heart diseases and myocardial injury. A high prevalence of HCV infection has been noted in patients with hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia/cardiomyopathy and myocarditis. Various arrhythmias, conduction disturbances and QT prolongation were also associated with HCV infection. A possible role of HCV infection in the pathogenesis of diabetes and atherosclerosis, and the role of immunogenetics of HCV cardiomyopathies is discussed. Recent studies suggest that mononuclear cells may be the major target of HCV, and clinical applications to test this new hypothesis are discussed.

Areas covered

In this review, we will evaluate the evidence that HCV causes various cardiovascular diseases, and discuss on the pathogenesis of these disorders.

Expert opinion

HCV is the cause of many different forms of heart disease worldwide, but their existence has not been recognized by most of cardiologists. The recognition and diagnosis are indispensable for the early treatment of these diseases. The diverse clinical manifestation of HCV infection and the presence of multiple extrahepatic disease syndromes could be explained by a new hypothesis that the target of HCV is leukocytes.

KEYWORDS:

• Arrhythmias
• atherosclerosis
• cardiomyopathy
• hepatitis C virus
• inflammation
• immunity
• leukocytes
• myocarditis
• pericarditis
• therapy

Article Highlights

• HCV is the cause of many different forms of heart disease worldwide, but their existence has not been recognized by most of cardiologists.

• HCV may cause hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia/cardiomyopathy and myocarditis, and may also cause various arrhythmias, conduction disturbances and QT prolongation.

• HCV infection may cause diabetes and atherosclerosis which are important risk factors of cardiovascular diseases.

• Immunogenetics play important role in the pathogenesis of HCV cardiomyopathies.

• The diverse clinical manifestation of HCV infection and the presence of multiple extrahepatic disease syndromes may be explained by a new hypothesis that the target of HCV is leukocytes.

Acknowledgments

We thank Dr. Steven Tracy for helpful comments.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose. 

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.