Efecto de la erradicación del virus de la hepatitis C sobre la activación endotelial en pacientes trasplantados hepáticos

Abstract

Hepatitis C virus (HCV) infection is one of the leading causes of morbidity and mortality worldwide with an estimated number of 350,000 deaths each year. In addition to liver damage, chronic HCV infection causes many other relevant extrahepatic complications, especially metabolic disorders and cardiovascular disease (CVD). Chronic HCV infection has been associated with an increased risk of carotid and coronary atherosclerosis, peripheral artery disease , cerebral and cardiovascular events and cardiovascular mortality.Furthermore, it increases the prevalence of metabolic disorders in patients infected with HCV compared to non-infected subjects, specifically in terms of diabetes mellitus (DM) and insulin resistance (IR). Not surprisingly, recurrence of HCV after liver transplantation (LT) has been also associated with the development of IR, DM and metabolic syndrome. Likewise, metabolic syndrome is highly prevalent in LT recipients, affecting approximately half of this patient population, thus increasing the risk of cardiovascular events after LT. Moreover, CVD is a major problem in LT recipients leading to an increase inmorbidity and in short- and long-term mortality. Furthermore, immunosuppressive therapy can be a contributing factor in developing cardiovascular risk (CVR) after LT. Therefore, the increased risk of CVD conferred by chronic HCV infection may be especially relevant in the post transplantsetting...