Effect of HCV infection on atherosclerosis in hemodialysis patients

To invastigate the effect of HCV infection on vascular functional and structurel changes in HD patients with chronic renal failure and to evaluate the role of inflammatory mediators and oxidative stres markers in this course. In this study, from four different HD center in Antalya 30 HCV seropositive HD patients, 31 HCV seronegative HD patients have enrolled and 30 HCV seropositive subjects with normal renal function, 31 HCV seronegative subjects with normal renal function, which referred Gastroenterology Deparment of Akdeniz University, have enrolled. To evaluate vascular functional and structural changes, PWV, AIx and Carotid Intima Media Thickness (CIMT), which are non-invasive, easy reproducible thecniques and have high predictive value for cardiovascular disease, were used. As an inflammatory mediators, which have been before shown that related with cardiovascular disease, ICAM-1, VCAM-1 and ELAM-1 among cell adhesion molecules, IL-6 among cytokines and VEGF among growth factors were analysed. As an oxidative stress markers MPO, which is a neutrophilic enzyme, was used. In addition to this, TOS and TAC were studied because of reflecting complete oxidative and antioxidative systems. In PWV and AIx measurement values, there were no significant differences between groups. From vascular structural measurements, right CIMT medium, right CIMT maksimum, left CIMT medium, general CIMT medium and general CIMT maksimum were were significantly higher in HCV seropositive HD group, HCV seronegative HD group and HCV seropositive with normal renal function group than control group (p:0.004, p:0.003, p:0.047, p:0.006, p:0.009). From inflammatory mediators, ICAM-1 levels were significantly higher in HCV seropositive with normal renal function group than control group (p:0.009). ELAM-1 levels were significantly higher in HCV seropositive with normal renal function than other 3 groups (p:0.005, p:0.012, p:0.001).. There were no significant differences in ICAM- 1 and ELAM-1 levels in HD groups. In VCAM-1 levels HCV seropositive HD group had significantley higher values than HCV seronegative HD group, HCV seronegative HD group had significantly higher values than HCV seropositive with normal renal function group and HCV seropositive with normal renal function group had significantly higher values than control group (p:0.003, p:0.000, p:0.004).. TAC values were significantly higher in HCV seronegative and seropositive HD groups according to HCV seronegative and seropositive with normal renal function groups (p:0.000, p:0.000, p:0.000, p:0.000).. According to this OSI values were significantly lower in HCV seronegative HD group according to HCV seronegative and seropositive with normal renal function groups and in HCV seropositive HD group according to HCV seropositive with normal renal function group (p:0.003, p:0.004, p:0.019). There were no significant differences in VEGF, IL-6, TOS and MPO levels. There were no correlation between inflammatory and oxidative stres markers with vascular functional and structural changes. We saw that mechanisms which are triggered by HCV, have changed according to additional factors belongs to HD and uremia. While these changes had additive effect on VCAM-1 levels; they had eliminating or inhibiting effects on ICAM-1 and ELAM-1 levels. We thoght that HCV infection have not had marked effect on vascular changes in course of HD patients and vascular changes could be formed by mediator mediated mechanisms which were different from measured in this study. Further studies are needed with groups which are large and homojen about cardiovascular disease risk factors to evaluate effect of HCV infection in course of HD patients Key words: HCV, HD, Chronic Renal Failure, VCAM-1, ICAM-1, ELAM-1, MPO, VEGF, TOS, TAC, IL-6, CIMT, PWV, AIx