Association between Hepatitis C Viral Load and the Inflammatory Markers [High Sensitive C - reactive protein and Serum Gamma-Glutamyl transferase] and Severity of Coronary Artery Disease

Abstract

The burden of HCV-derived heart diseases is global, with a higher prevalence in low- and middle-income countries. Egypt has the highest prevalence of HCV in the world, which is the cause of many different forms of heart disease, and yet few cardiologists are aware of it as an etiology of heart disease. Hepatitis C virus infection is thought to be associated with an increased risk of coronary heart disease events. As the coronary artery disease is one of the major causes of mortality in all human populations, therefore detection of its risk factors and preventing population exposure to them should be considered to attenuate health burden imposed by coronary artery disease (CAD). Persons with HCV infection are at an increased risk of developing hepatic steatosis, which shares many clinical features with the metabolic syndrome. Hepatic steatosis has also been associated with elevated serum levels of markers of inflammation and endothelial dysfunction. These factors suggest a biologically plausible mechanism of increased risk of CAD in at least a subset of chronic hepatitis C patients. High-sensitivity C-reactive protein (hsCRP) as a biomarker of endothelial inflammation and dysfunction have been used in studies of atherosclerosis, but not studied in chronic hepatitis C infection patients. It is uncertain why increased Gamma-glutamyl transferase (GGT) level is associated with