Short communicationHepatitis C virus RNA localization in human carotid plaques
Section snippets
Background
After the first report of an association of viral infection and atherosclerosis in 1970,1 evidence is accumulating that infections are involved in the development and progression of atherosclerosis, with special focus on carotid and coronary lesions.2, 3 The pathogenetic mechanisms may vary and are still poorly understood. Localization of the infective agent inside the plaque has been shown for most pathogens for whom a deeper evidence of such an association exists, suggesting the importance of
Objective
Based on these observations, the aim of the study was to prospectively evaluate the possibility of the presence of HCV infection in carotid plaque tissue.
Study population
Plaque and serum samples were obtained from 10 consecutive anti-HCV-positive patients with chronic ischemic heart disease and hemodynamic carotid stenosis who underwent percutaneous transluminal carotid angioplasty (Table 1) and from 9 age/sex matched anti-HCV-negative (control) patients. All patients had >80% carotid stenosis grade and were identified as candidates for carotid endoarterectomy according to the routine medical practices of the vascular Surgery Department.
The main demographic,
Results
HCV RNA sequences were detected in five serum samples (pts. 2, 6, 7, 9 and 10) and seven plaque tissue samples (pts. 3, 4, 5, 6, 7, 9 and 10) from anti-HCV-positive patients (Table 1 and Fig. 1). The mean viral load (detection of positive-strand HCV RNA) in serum was 7.79 ± 4.21 × 105 IU/mL. No HCV RNA sequences were detected in anti-HCV-negative subjects (data not shown). HCV genotype analysis showed five out of seven typeable patients were infected by HCV genotype 2 (pts. 3, 4, 5, 7 and 10) and
Discussion
Available data suggest that HCV is an independent risk factor for carotid atherosclerosis, even though the mechanism involved is unknown. The present study, for the first time, demonstrates the presence of HCV genomic sequences and replicative intermediates in plaque tissues, strongly suggesting the possibility of an active infection of the carotid plaque. The detection of HCV sequences in the sole plaque tissue in three patients further supports viral localization rather than contamination by
Competing interests
None declared.
Ethical approval
Not required.
Acknowledgments
This work was supported by grants from the Associazione Italiana per la Ricerca sul Cancro (AIRC), Istituto Toscano Tumori (ITT) and Ente Cassa di Risparmio di Firenze.
References (32)
- et al.
Extrahepatic manifestations of hepatitis C virus infection
Clin Liver Dis
(2008) - et al.
Association between persistent lymphatic infection by hepatitis C virus after antiviral treatment and mixed cryoglobulinemia
Blood
(2008) - et al.
High density lipoproteins facilitate hepatitis C virus entry through the scavenger receptor class B type I
J Biol Chem
(2005) - et al.
Hepatitis C virus, ER stress, and oxidative stress
Trends Microbiol
(2005) - et al.
Association between hepatitis C virus seropositivity, carotid-artery plaque, and intima–media thickening
Lancet
(2002) - et al.
Effect of antiviral treatment in patients with chronic HCV infection and t(14;18) translocation
Blood
(2003) - et al.
Prevalence of mixed infection by different hepatitis C virus genotypes in patients with hepatitis C virus-related chronic liver disease
J Lab Clin Med
(1999) - et al.
Infection of peripheral mononuclear blood cells by hepatitis C virus
J Hepatol
(1992) - et al.
Virus-induced atherosclerosis
J Exp Med
(1978) Atherosclerosis—an inflammatory disease
N Engl J Med
(1999)
Impact of infectious burden on progression of carotid atherosclerosis
Stroke
Predisposition to atherosclerosis by infections: role of endothelial dysfunction
Circulation
Chlamydia pneumoniae as an emerging risk factor in cardiovascular disease
JAMA
Porphyromonas gingivalis mediated periodontal disease and atherosclerosis: disparate diseases with commonalities in pathogenesis through TLRs
Curr Pharm Des
High prevalence of latently present cytomegalovirus in arterial walls of patients suffering from grade III atherosclerosis
Am J Pathol
Inflammation and atherosclerosis: novel insights into plaque formation and destabilization
Stroke
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