Publication: Efecto de la erradicación del virus de la hepatitis C sobre la activación endotelial en pacientes trasplantados hepáticos
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2022-03-31
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Universidad Complutense de Madrid
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Abstract
La infección por el virus de la hepatitis C (VHC) es una de las principales causas de morbilidad y mortalidad en todo el mundo, con un número estimado de 350.000 muertes al año. Además del daño a nivel hepático, la infección crónica por el VHC provoca muchas otras complicaciones extrahepáticas relevantes, como los trastornos metabólicos y la enfermedad cardiovascular (ECV). La infección por el VHC se ha asociado a un mayor riesgo de desarrollo de aterosclerosis carotídea y coronaria, arteriopatía periférica, eventos cerebrales y cardiovasculares y mortalidad cardiovascular. Asimismo, se ha observado una mayor prevalencia de trastornos metabólicos en los pacientes infectados por el VHC en comparación con los sujetos no infectados, concretamente en lo que respecta a la diabetes mellitus (DM) y la resistencia a la insulina (IR). La recurrencia del VHC tras el trasplante hepático (TH) también se ha asociado al desarrollo de RI, DM11 y síndrome metabólico. Asimismo, el síndrome metabólico es altamente prevalente en los receptores de TH, afectando aproximadamente a la mitad de esta población de pacientes, lo cual genera un aumento del riesgo de eventos cardiovasculares tras el TH. Del mismo modo, la ECV es un problema relevante en los receptores de TH, condicionando un aumento de la morbilidad y de la mortalidad a corto y largo plazo. Por otro lado, el tratamiento inmunosupresor constituye un factor adicional que contribuye al riesgo cardiovascular (RCV) tras el TH. Por tanto, teniendo en cuenta estas consideraciones, el riesgo aumentado de ECV que confiere la infección crónica por el VHC es de especial relevancia en el contexto del TH...
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...
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...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 09-10-2021