Manifestations of chronic hepatitis C virus infection beyond the liver.
In addition to its effects in the liver, chronic hepatitis C virus (HCV) infection can have serious consequences for other organ systems. Extrahepatic manifestations include mixed cryoglobulinemia (MC) vasculitis, lymphoproliferative disorders, renal disease, insulin resistance, type 2 diabetes, sicca syndrome, rheumatoid arthritis-like polyarthritis, and autoantibody production; reductions in quality of life involve fatigue, depression, and cognitive impairment. MC vasculitis, certain types of lymphoma, insulin resistance, and cognitive function appear to respond to anti-HCV therapy. However, treatments for HCV and other biopsychosocial factors can reduce quality of life and complicate management. HCV treatment has a high overall cost that increases when extrahepatic manifestations are considered. HCV appears to have a role in the pathogenesis of MC vasculitis, certain types of lymphoma, and insulin resistance. Clinicians who treat patients with HCV infections should be aware of potential extrahepatic manifestations and how these can impact and alter management of their patients.
Jacobson
Ira M
IM
Center for the Study of Hepatitis C, Joan and Sanford I. Weill Medical College of Cornell University, New York, New York 10021, USA. imj2001@med.cornell.edu
Cacoub
Patrice
P
Dal Maso
Luigino
L
Harrison
Stephen A
SA
Younossi
Zobair M
ZM
D000998:Antiviral Agents / Q000627:therapeutic use*; D003449:Cryoglobulinemia / Q000453:epidemiology / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D006801:Humans; D008223:Lymphoma / Q000453:epidemiology / Q000209:etiology; D011788:Quality of Life; D014657:Vasculitis / Q000453:epidemiology / Q000209:etiology
D000998:Antiviral Agents