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Metabolic and cardiovascular risk profiles and hepatitis C virus infection in rural Egypt
  1. D Marzouk1,
  2. J Sass2,
  3. I Bakr1,
  4. M El Hosseiny1,
  5. M Abdel-Hamid3,
  6. C Rekacewicz2,
  7. N Chaturvedi4,
  8. M K Mohamed1,
  9. A Fontanet2
  1. 1Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  2. 2Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France
  3. 3Viral Hepatitis Research Laboratory, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
  4. 4National Heart and Lung Institute, Imperial College, London, UK
  1. Correspondence to:
    Dr Arnaud Fontanet
    Emerging Diseases Epidemiology Unit, Institut Pasteur, 28 rue du Docteur Roux, Paris 75015, France; fontanet{at}pasteur.fr

Abstract

Background and aim: To investigate the relationship between lipid profiles and diabetes with past and chronic hepatitis C virus (HCV) infection among village residents of Egypt.

Patients and methods: Fasting lipids and glucose profiles were compared among adults never infected with HCV (negative HCV antibodies), infected in the past (positive HCV antibodies and negative HCV RNA) and chronically infected (positive HCV antibodies and HCV RNA).

Results: Of the 765 participants, 456 (59.6%) were female, and median age was 40 (range 25–88) years. Chronic HCV infection was present in 113 (14.8%) and past infection in 67 (8.8%). After adjustment for age and sex, participants with chronic HCV infection had lower plasma low density lipoproteins (LDL) cholesterol and triglyceride levels compared with those never infected (age and sex adjusted differences (95% CI) were −19.0 (−26.3 to −11.7) mg/dl and −26.2 (−39.0 to −13.3) mg/dl, respectively). In contrast, participants with cleared HCV infection had higher triglyceride levels compared with those never infected (age and sex adjusted difference (95% CI) was +16.0 (0.03 to 31.9) mg/dl). In multivariate analysis, participants with chronic HCV infection were more likely to have diabetes (OR 3.05, 95% CI 1.19 to 7.81) compared with those never infected, independent of LDL cholesterol levels.

Conclusion: In conclusion, this community based study has shown that in a single population, chronic HCV infection is associated with glucose intolerance and, despite that, a favourable lipid pattern. An intriguing finding was the high triglyceride levels observed among participants with past infection, suggesting that elevated triglycerides at the time of acute infection may facilitate viral clearance.

  • BMI, body mass index
  • EIA, enzyme immunoassay
  • HCV, hepatitis C virus
  • HDL, high density lipoprotein
  • LDL, low density lipoprotein
  • NHTMRI, National Hepatology and Tropical Medicine Research Institute
  • VLDL, very low density lipoprotein
  • WHR, waist hip ratio
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Footnotes

  • Published Online First 6 September 2006

  • The study was supported financially by the European Community (INCOMED Programme: Viral Hepatitis Surveillance in Mediterranean Countries, Contract ICA3-CT-2000-30011) and the Agence Nationale de Recherches sur le SIDA, hépatites B et C-France (ANRS 1211).

  • Conflicts of interest: None

  • The study protocol was approved by the Egyptian Ministry of Health and Population Institutional Review Board and a local ethics committee set up for hepatitis studies in Egypt.

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