Cardiovascular Manifestations of Viral Hepatitis: A Systematic Review and Meta-Analysis

AuthorDan Lien
AuthorYang Jiaoen
AuthorHaiwei Yuen
AuthorSijian Fengen
OrcidDan Li [0009-0000-2705-1789]en
OrcidYang Jiao [0009-0003-3245-1412]en
OrcidHaiwei Yu [0009-0007-8928-6226]en
OrcidSijian Feng [0009-0000-8930-4980]en
Issued Date2026-12-31en
AbstractBackground: Chronic viral hepatitis, particularly hepatitis B virus (HBV) and hepatitis C (HCV), has been associated with systemic inflammation and endothelial dysfunction, which may increase cardiovascular risk. However, the magnitude of this risk remains unclear. Objectives: This systematic review and meta-analysis aimed to quantify the association between chronic viral hepatitis and cardiovascular disease (CVD) outcomes. Methods: We searched PubMed, Scopus, and Web of Science for observational studies published from January 2019 to May 2025. Studies reporting cardiovascular events in adults with HBV or HCV were included. Data were extracted independently by two reviewers. The primary effect measure was the observed-to-expected (O/E) ratio. Meta-analysis was conducted using a random-effects model, and heterogeneity and publication bias were assessed. Results: Eight papers were included in the meta-analysis to assess the relationship between hepatitis infection and the risk of CVD. The combined O/E ratio was 1.33 (95% CI: 1.24 to 1.42), indicating a 33% increased risk of CVD in patients with hepatitis compared to expected rates in the general population. The 95% prediction interval (1.24 to 1.43) showed consistent results across studies. No significant publication bias was detected according to Egger’s test (P = 0.245), Egger’s multiplicative overdispersion test (P = 0.260), or the Macaskill test (P = 0.813). Funnel plot analyses also supported the absence of notable asymmetry. Conclusions: This meta-analysis demonstrates a significantly increased cardiovascular risk in patients with viral hepatitis, as reflected by an elevated pooled O/E ratio.en
DOIhttps://doi.org/10.5812/hepatmon-167192en
URIhttps://brieflands.com/journals/hepatmon/articles/167192en
KeywordCardiovascular Diseasesen
KeywordHepatitis B Virusen
KeywordHepatitis C Virusen
KeywordObserved-to-Expected Ratioen
KeywordForest Ploten
PublisherBrieflandsen
TitleCardiovascular Manifestations of Viral Hepatitis: A Systematic Review and Meta-Analysisen
TypeSystematic Reviewen

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