The possible role of hepatitis A virus in the pathogenesis of atherosclerosis

The possible association between hepatitis A virus (HAV) infection and coro nary artery disease (CAD) was studied. Blood from 391 patients undergoing c oronary angiography was tested for serum IgG antibodies to HAV and C-reacti ve protein (CRP), Of the 391 patients, 205 (52%) had anti-HAV IgG antibodie s. CAD prevalence was 74% in HAV-seropositive and 52% in HAV-seronegative p atients (P < .0001); significance persisted after adjustment for either tra ditional CAD risk factors or for risk factors plus other infectious agents (cytomegalovirus, Chlamydia pneumoniae, Helicobacter pylori, and herpes sim plex virus). In addition, CRP levels were significantly higher in HAV-serop ositive than in HAV-seronegative patients (P = .013) in both univariate and multivariate analyses. Logistic regression analysis demonstrated that HAV seropositivity is an independent predictor of risk for CAD and elevated CRP levels. HAV infection is therefore associated with CAD, which raises the p ossibility that this virus may play a causal role in atherogenesis.