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Thromb Haemost 2016; 116(05): 958-966
DOI: 10.1160/TH16-03-0185
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH

The risk of venous thromboembolism in patients with hepatitis C

A systematic review and meta-analysis
Pasquale Ambrosino
1   Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
,
Luciano Tarantino
2   Department of Surgery, Interventional Hepatology Unit, Andrea Tortora Hospital, Pagani, Italy
,
Livio Criscuolo
1   Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
,
Aurelio Nasto
3   Department of Surgery, Unit of General Surgery and Oncology, Andrea Tortora Hospital, Pagani, Italy
,
Aldo Celentano
1   Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
,
Matteo Nicola Dario Di Minno
4   Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University, Naples, Italy
5   Centro Cardiologico Monzino, IRCCS, Milan, Italy
› Author Affiliations
Further Information

Publication History

Received: 04 March 2016

Accepted after major revision: 07 June 2016

Publication Date:
30 November 2017 (online)

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Summary

Some studies suggest that patients with hepatitis C virus (HCV) infection have an increased risk of deep venous thrombosis (DVT) and pulmonary embolism (PE). Unfortunately, available data on this association are contrasting. A systematic review and meta-analysis of literature studies was performed to evaluate the risk of venous thromboembolism (VTE) associated with HCV. Studies reporting on VTE risk associated with HCV were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases. Six studies (10 data-sets) showed a significantly increased VTE risk in 100,364 HCV patients as compared with 8,471,176 uninfected controls (odds ratio [OR]: 1.900; 95 % confidence interval [CI]: 1.406, 2.570; p<0.0001). These results were confirmed when specifically considering the risk of DVT (6 studies, OR: 1.918; 95 %CI: 1.351, 2.723; p<0.0001), whereas a trend towards an increased risk of PE was documented in HCV patients (4 studies, OR: 1.811; 95 %CI: 0.895, 3.663; p=0.099). The increased VTE risk associated with HCV infection was consistently confirmed when analysing four studies reporting adjusted risk estimates (OR: 1.876; 95 %CI: 1.326, 2.654; P<0.0001), and after excluding studies specifically enrolling populations exposed to transient risk factors for VTE (4 studies, OR: 1.493; 95 %CI: 1.167, 1.910; p=0.001). Meta-regression models suggested that age and male gender may significantly impact on the risk of VTE associated with HCV-positivity. Results of our metaanalysis suggest that HCV-infected subjects may exhibit an increased risk of VTE. However, further high quality studies are needed to extend and confirm our findings.

Supplementary Material to this article is available online at www.thrombosis-online.com.

Keywords

Hepatitis C - viral hepatitis - deep venous thrombosis - pulmonary embolism - venous thromboembolism

 

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