Metabolic and Cardiovascular Complications in HIV/HCV-Co-infected Patients

Roger Bedimo, Oladapo Abodunde

Research output: Contribution to journalReview article

10 Scopus citations

Abstract

Purpose of Review: Fifteen to thirty percent of HIV-infected persons in North America and Europe are co-infected with chronic hepatitis C (HCV). The latter is associated with a significant number of extra-hepatic metabolic complications that could compound HIV-associated increased cardiovascular risk. This article reviews the basic science and epidemiologic and clinical evidence for increased cardio-metabolic risk among HIV/HCV-co-infected patients and discusses potential underlying mechanisms. We will finally review the impact of control of HCV viremia on the cardio-metabolic morbidity and mortality of HIV/HCV-co-infected patients. Recent Findings: HCV infection is associated with a number of immune-related complications such as cryoglobulinemia but also metabolic complications including dyslipidemias, hepatic steatosis, insulin resistance, diabetes, and chronic kidney disease. The incidence of these complications is higher among HIV-co-infected patients and might contribute to increased mortality. The potential mechanisms of increased cardiovascular risk among HIV/HCV-co-infected subjects include endothelial dysfunction, chronic inflammation and immune activation, the cardio-metabolic effects of HCV-induced hepatic steatosis and fibrosis or insulin resistance, and chronic kidney disease. However, epidemiologic studies show discordant findings as to whether HCV co-infection further increases the risk of atherosclerotic cardiovascular diseases (acute myocardial infarctions and strokes) among HIV-infected patients. Nonetheless, successful treatment of HCV is associated with significant improvements in cardio-metabolic risk factors including diabetes mellitus. Summary: HCV co-infection is associated with a higher incidence of metabolic complications—and likely increased risk of cardiovascular events—that might contribute to increased mortality in HIV. These appear to improve with successful HCV therapy.

Original languageEnglish (US)
Pages (from-to)328-339
Number of pages12
JournalCurrent Heart Failure Reports
Volume13
Issue number6
DOIs
Publication statusPublished - Dec 1 2016

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Keywords

  • Cardiovascular events
  • Hepatitis C
  • HIV
  • Metabolic complications

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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