Effect of Chronic Hepatitis C Virus Infection on Bone Disease in Postmenopausal Women

Background & Aims: Limited data are available on the contribution of chronic 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 turnover markers (BTMs), compared with 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 BTMs 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 = .007). PCR⁺ women with fractures were postmenopausal for a longer time (median, 15.5, range, 5-20 years vs 4.5, range, 1-20 years in PCR⁺ women without fractures; P = .033), had lower BMD at the hip (0.79, range, 0.77-0.9 g/cm² vs 0.96, range, 0.81-1.10 g/cm²; P = .007), and had a lower body mass index (23.7, range 21.2-28.5 kg/m² vs 25.6, range 22.1-36.6 kg/m²; P = .035). There was no difference in liver disease severity or BTMs in PCR⁺ women with or without fractures. Conclusions: Chronic HCV infection did not lead to discernable metabolic bone disease in postmenopausal women, but it might be a risk factor for bone fractures, so preventive measures should be introduced. To view this article's video abstract, go to the AGA's YouTube Channel.