Nanda KS, Ryan EJ, Murray BF, Brady JJ, McKenna MJ, Nolan N, O'Farrelly C, Hegarty JE
The effect of chronic hepatitis C virus infection on bone disease in postmenopausal women. [JOURNAL ARTICLE]
Clin Gastroenterol Hepatol 2009 Jan 24.
BACKGROUND & AIMS:: Limited data are available on the contribution of chronic hepatitis C virus (HCV) infection to the development of bone disease in postmenopausal women. We studied whether women who acquired HCV infection through administration of HCV genotype 1b-contaminated anti-D immunoglobulin from a single source had decreased bone mineral density (BMD) or altered levels of bone formation and resorption markers, compared to women who spontaneously resolved infection or age-matched healthy controls.
METHODS:: From a cohort of postmenopausal Irish women, we compared BMD, determined by dual-energy X-ray absorptiometry and a panel of bone turnover markers (BTM), in 20 women chronically infected with HCV (PCR+), 21 women who had spontaneously resolved infection (PCR-) and 23 age-matched healthy controls.
RESULTS:: Levels of BTMs and BMD were similar in PCR+ and PCR- women and healthy age-matched controls. However, there was an increased frequency of fractures in PCR+ (n=6) compared with PCR- women (n=0), (p=0.007). PCR+ women with fractures were postmenopausal for longer (median 15.5 [range 5-20] vs 4.5 [1-20] years in PCR+ women without fractures; p=0.033), had lower BMD at the hip (0.79 [0.77-0.9] vs 0.96 [0.81-1.10] g/cm(2); p=0.007) and had a lower body mass index 23.7 (21.2-28.5) vs. 25.6 (22.1-36.6) kg/m2, p=0.035). There was no difference in liver disease severity or bone turnover markers in PCR+ women with or without fractures.
CONCLUSIONS:: Chronic HCV infection did not lead to discernable metabolic bone disease in postmenopausal women, but may be a risk factor for bone fractures, so preventive measures should be introduced.
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