Global burden of atherosclerotic cardiovascular disease in people living with the hepatitis C virus: a systematic review, meta-analysis and modelling study

Lee, K. K. et al. (2019) Global burden of atherosclerotic cardiovascular disease in people living with the hepatitis C virus: a systematic review, meta-analysis and modelling study. Lancet Gastroenterology and Hepatology, 4(10), pp. 794-804. (doi: 10.1016/S2468-1253(19)30227-4) (PMID:31377134) (PMCID:PMC6734111)

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Abstract

Background: More than 70 million people worldwide are estimated to have hepatitis C virus (HCV) infection. Emerging evidence indicates an association between HCV and atherosclerotic cardiovascular disease. We aimed to determine the association between HCV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HCV. Methods: For this systematic review and meta-analysis, we searched MEDLINE, Embase, Ovid Global Health, and Web of Science databases from inception to May 9, 2018, without language restrictions, for longitudinal studies that evaluated the risk ratio (RR) of cardiovascular disease in people with HCV compared with those without HCV. Two investigators independently reviewed and extracted data from published reports. The main outcome was cardiovascular disease, defined as hospital admission with, or mortality from, acute myocardial infarction or stroke. We calculated the pooled RR of cardiovascular disease associated with HCV using a random-effects model. Additionally, we calculated the population attributable fraction and disability-adjusted life-years (DALYs) from HCV-associated cardiovascular disease at the national, regional, and global level. We also used age-stratified and sex-stratified HCV prevalence estimates and cardiovascular DALYs for 100 countries to estimate country-level burden associated with HCV. This study is registered with PROSPERO, number CRD42018091857. Findings: Our search identified 16 639 records, of which 36 studies were included for analysis, including 341 739 people with HCV. The pooled RR for cardiovascular disease was 1·28 (95% CI 1·18–1·39). Globally, 1·5 million (95% CI 0·9–2·1) DALYs per year were lost due to HCV-associated cardiovascular disease. Low-income and middle-income countries had the highest disease burden with south Asian, eastern European, north African, and Middle Eastern regions accounting for two-thirds of all HCV-associated cardiovascular DALYs. Interpretation: HCV infection is associated with an increased risk of cardiovascular disease. The global burden of cardiovascular disease associated with HCV infection was responsible for 1·5 million DALYs, with the highest burden in low-income and middle-income countries.

Item Type:Articles
Additional Information:British Heart Foundation Clinical Research Training Fellowship (FS/18/25/33454), Intermediate Clinical Research Fellowship (FS/19/17/34172), Senior Clinical Research Fellowship (FS/16/04/32023), Chair Award (CH/09/002) and Centre of Excellence Award (RE/13/3/30183), Wellcome Trust Intermediate Clinical Fellowship (201492/Z/16/Z) and Senior Investigator Award (WT103782AIA).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McAllister, Professor David and Mills, Professor Peter and Newby, Professor David
Authors: Lee, K. K., Stelzle, D., Bing, R., Anwar, M., Strachan, F., Bashir, S., Newby, D. E., Shah, J. S., Chung, M. H., Bloomfield, G. S., Longenecker, C. T., Bagchi, S., Kottilil, S., Blach, S., Razavi, H., Mills, P. R., Mills, N. L., McAllister, D. A., and Shah, A. S.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Lancet Gastroenterology and Hepatology
Publisher:Elsevier
ISSN:2468-1253
ISSN (Online):2468-1253
Published Online:31 July 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Lancet Gastroenterology and Hepatology 4(10):794-804
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
754453Combining efficacy estimates from clinical trials with the natural history obtained from large routine healthcare databases to determine net overall treatment benefitsDavid McAllisterWellcome Trust (WELLCOTR)201492/Z/16/ZIHW - PUBLIC HEALTH