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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Naïve hepatitis B e antigen-negative chronic hepatitis B patients are at risk of carotid atherosclerosis: A prospective study
Mar Riveiro-Barciela, Cristina Marcos-Fosch, Fernando Martinez-Valle, Fabrizio Bronte, Olimpia Orozco, Isidro Sanz-Pérez, Daniele Torres, Maria-Teresa Salcedo, Salvatore Petta, Rafael Esteban, Antonio Craxi, Maria Buti
Mar Riveiro-Barciela, Cristina Marcos-Fosch, Rafael Esteban, Maria Buti, Department of Medicine of the UAB, Hospital Universitari Vall d’Hebron, Barcelona 08035, Spain
Mar Riveiro-Barciela, Rafael Esteban, Maria Buti, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid 28029, Spain
Fernando Martinez-Valle, Olimpia Orozco, Isidro Sanz-Pérez, Systemic Autoimmune Diseases Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona 08035, Spain
Fabrizio Bronte, Daniele Torres, Salvatore Petta, Antonio Craxi, Sezione di Gastroenterologia, Di.Bi.M.I.S, University of Palermo, Palermo 90133, Italy
Maria-Teresa Salcedo, Pathology Department, Hospital Universitari Vall d'Hebron, Barcelona 08035, Spain
Author contributions: Buti M acts as guarantor of this article; Riveiro-Barciela M, Marcos-Fosch C, Martinez-Valle F, Craxi A and Buti M drafted the manuscript; Riveiro-Barciela M, Marcos-Fosch C, Martinez-Valle F, Bronte F, OrozcoO, Sanz-Pérez I, Torres D and Salcedo MT acquired the data; Riveiro-Barciela M, Marcos-Fosch C, Bronte F and Petta S analyzed the data; All authors approved the final version of the article.
Supported by IV Fellowship Gilead-Research projects in HIV and hepatitisfunded by Gilead Science, No. GLD16_00057.
Institutional review board statement: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. It was approved by the Ethics Committee of both hospitals (PR(AG)245/2015).
Informed consent statement: Informed verbal consent was obtained from all individual participants included in the study and recorded at the medical records.
Conflict-of-interest statement: Riveiro-Barciela M has received research grants from Gilead and served as speaker for Gilead and Grifols. Esteban R has received research grants from Gilead and has served as advisors for Gilead, Bristol-Myers Squibb and Novartis. Buti M has received research grants from Gilead and has served as advisors for Gilead, Bristol-Myers Squibb and Novartis. The rest of authors have no personal or financial conflicts of interest.
Data sharing statement: Technical appendix, and dataset available from the corresponding author at [mbuti@vhebron.net]. Participants gave informed verbal consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Maria Buti, MD, PhD, Chief Doctor, Full Professor, Senior Scientist, Department of Medicine of the UAB, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebrón 119-129, General Hospital Building, Hepatology Unit, Barcelona 08035, Spain. mbuti@vhebron.net
Received: February 16, 2021
Peer-review started: February 16, 2021
First decision: May 1, 2021
Revised: May 13, 2021
Accepted: July 9, 2021
Article in press: July 9, 2021
Published online: August 14, 2021
ARTICLE HIGHLIGHTS
Research background
There is an increased risk of atherosclerosis in patients with chronic hepatitis C and also in individuals with human immunodeficiency virus infection.
Research motivation
There is scarce data on the potential role of hepatitis B virus infection as a cardiovascular risk factor.
Research objectives
To assess whether the stage of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus infection impacts the presence of both carotid plaques and subclinical atherosclerosis and to evaluate if the risk of both carotid plaques and subclinical atherosclerosis in HBeAg-negative patients differ to those of healthy controls.
Research methods
Prospective case-control study with 402 subjects prospectively recruited at the outpatient clinic. Anthropomorphic and metabolic measures, liver stiffness and carotid Doppler ultrasound were performed.
Research results
Patients with HBeAg-negative chronic hepatitis B presented a higher rate of carotid plaques than healthy controls (32.7% vs 18.4%, P = 0.002), but no differences were observed between controls and hepatitis B inactive carriers. HBeAg-negative chronic hepatitis B was an independent risk factor for carotid plaques as well as age, dyslipidemia and central obesity.
Research conclusions
These results suggest that hepatitis B infection may have a role as a cardiovascular risk factor in patients with chronic hepatitis B.
Research perspectives
Further studies should assess the potential impact of oral antiviral therapy on early atherosclerosis related to hepatitis B virus infection.
