Hepatitis C infection and clearance: impact on atherosclerosis and cardiometabolic risk factors

BackgroundChronic hepatitis C (HCV) infection is associated with diabetes and favourable lipids.ObjectiveTo study the effect of this paradox on atherosclerosis and cardiometabolic response to HCV clearance.DesignCross-sectional study.SettingEgypt.Participants329 chronically infected, 173 with cleared infection and 795 never infected participants aged ≥35 attended for baseline investigations. A subsample of 192, 115 and 187, respectively, underwent ultrasound.Main outcome measuresDiabetes, fasting glucose, lipids and fat deposition on ultrasound. Carotid intima-media thickness (IMT) measured atherosclerosis.ResultsDiabetes prevalence was raised (10.1% (95% CI 6.6 to 13.6), p=0.04) in HCV chronic, and cleared (10.1% (5.6 to 14.8), p=0.08) individuals versus 6.6% (4.9 to 8.3) in those never infected. Mesenteric fat was raised in chronic (36.4 mm (34.5 to 38.2), p=0.004), and cleared infection (37.8 (35.6 to 40.0), p