Accelerated Phenotypic Aging Associated with Hepatitis C Infection: Results from the U.S. National Health and Nutrition Examination Surveys 2015-2018

Abstract Background Chronic hepatitis C virus (HCV) infection is associated with early onset of chronic diseases and increased risk of chronic disorders. Chronic viral infections have been linked to accelerated biological aging based on epigenetic clocks. In this study, we aimed to investigate the association between HCV infection and clinical measures of biological aging among 8 306 adults participating in the 2015–2018 waves of the National Health and Nutrition Examination Survey (NHANES). Methods NHANES 2015–2018 participants aged 20 years and older who had complete data on clinical blood markers and HCV-related tests were included in the current study. We estimated biological age using 2 approaches including phenotypic age (PhenoAge) and allostatic load (AL) score based on 9 clinical biomarkers. Results After adjusting for demographic and other confounding factors, HCV antibody-positivity was associated with advanced PhenoAge (β = 2.43, 95% confidence interval: 1.51–3.35), compared with HCV antibody-negativity. Additionally, both active HCV infection (HCV RNA (+)) and resolved infection were associated with greater PhenoAge acceleration. The positive association with the AL score was not statistically significant. We did not observe any significant interactions of potential effect modifiers, including smoking and use of drug/needle injection, with HCV infection on measures of biological aging. Conclusions Our findings suggest that HCV infection is independently associated with biological aging measured by phenotypic age in the U.S. general population. Further studies are warranted to confirm the findings.