Hepatitis C virus infection is a risk factor for gallstone disease: a prospective hospital‐based study of patients with chronic viral C hepatitis

Abstract

We evaluated the prevalence and the risk factors for gallstone disease in patients with chronic hepatitis C infection. We investigated 453 consecutively admitted patients with chronic infection with hepatitis C virus (HCV) (cirrhosis excluded) and 879 patients without liver disease (October 2006-April 2007). Gallstone disease was diagnosed if gallstones were present at ultrasonography or if there had been a previous cholecystectomy. Variables evaluated were age, gender, gallstone heredity, body mass index, waist circumference, parity, serum lipids, fatty liver, arterial hypertension, diabetes mellitus and metabolic syndrome (International Diabetes Federation criteria). Informed consent was obtained from all patients. We found that 88 of 453 (19%) patients with chronic HCV hepatitis (age 50.1 +/- 11.7 years) and 153 of 879 (17%) controls (age 60.6 +/- 12.6 years) had gallstone disease (GD). Abdominal obesity (OR = 2.108, 95% CI 1.287-3.452) and steatosis (OR = 3.699, 95% CI 2.277-6.008) were risk factors for GD in HCV patients. Gallstone heredity, dyslipidaemia, type 2 diabetes mellitus and metabolic syndrome increased the risk for GD in controls vs HCV patients. Our study shows that even HCV patients with chronic hepatitis but not cirrhosis have an increased prevalence of gallstones. Compared with controls, gallstones are present in HCV patients at a younger age and are associated with central obesity and liver steatosis, but not with gallstone heredity, dyslipidaemia, diabetes mellitus or metabolic syndrome. Although we could not establish a temporal relationship, the association between HCV infection and gall stone disease is real and appears to be causally linked, at least in predisposed individuals (obese and with liver steatosis).

Gallstones: Environment, Lifestyle and Genes

“…A US cohort comprising of 13,465 people from the National Health and Nutrition Examination Survey (NHANES) III cohort found an increased risk of gallstones (OR 3.2, 95% CI 1.08–9.45) and cholecystectomy (OR 4.57, 95% CI 1.57–13.27) in men with HCV compared to HCV-negative men [113]. The above association was not reported in women in this study, however the increased risk of gallstones in both genders with HCV has been supported by others [114,115]. In HCV patients, Acalovschi et al [114] reports central obesity and liver steatosis as significant risk factors both of which have been linked to insulin resistance [116,117].…”

“…In HCV patients, Acalovschi et al [114] reports central obesity and liver steatosis as significant risk factors both of which have been linked to insulin resistance [116,117]. In cholesterol gallstones as well as in chronic HCV infection, insulin resistance is suggested as being their causal link given its ability to increase bile cholesterol saturation [114]. …”

Sex differences in prevalence and risk factors of asymptomatic cholelithiasis in Korean health screening examinee

“…Previous studies have reported conflicting results for chronic hepatitis B infection as a risk factor for cholelithiasis, [21,22] and previous reports suggested chronic hepatitis C as a risk factor for cholelithiasis. [23] Chronic liver inflammation increases the risk of cholelithiasis [24] and chronic inflammation caused by chronic hepatitis B or C might increase the risk of cholelithiasis. Risk of cholelithiasis was reported to show correlation with the degree of liver cirrhosis.…”

Risk Factors for Gallstones; Is 5 F Mnemonic Still Valid?

“…5,6 Western studies shows that the contributing risk factors associated with gallstones are ethnicity, genetics, gender (F > M), age,obesity, fertility, metabolic diseases, hepatitis C, cirrhosis, and high caloric intake. [7][8][9][10] The relationship between blood cholesterol, LDL, and HDL levels and cholesterol gallstone formation is complex and multifarious.…”