title: The role played by gender in viral hepatitis.
abstract: Although not a classical target for estrogens, the liver is a target for their action and is sensitive to their deprivation. The occurrence of menopause is accompanied by a chain of events depending on the progressive estrogen deprivation that eventually leads to a shift from a low inflammatory to a high inflammatory state. This has a series of well-known consequences in many different organs and tissues (bone, heart, brain, body fat etc.) among which the liver is particularly interesting. The consequences are extremely evident in HCV-positive women in whom HCV infection and menopause cooperate to induce higher necro-inflammatory features, increased hepatic steatosis and eventually faster progression of fibrosis. In addition, menopause is the strongest negative factor for sustained viral response (SVR) in HCV-positive females, especially HCV genotype 1 (in whom menopause was the only independent factor for failure of antiviral therapy). This suggests that HCV-positive women should be treated early during fertile age to obtain maximal response to antiviral therapy.
authors.affiliation: Division of Gastroenterology, Azienda Ospedaliero-Universitaria Policlinico di Modena, Università degli Studi di Modena e Reggio Emilia , Modena , Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Bernabucci
authors.forename: Erica
authors.initials: E
authors.lastname: Villa
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008593:Menopause; D010976:Platelet Count; D012727:Sex Characteristics
chemical_list: D000998:Antiviral Agents
keywords: Boceprevir; Menopause; hepatitis C; hormone replacement therapy; interferon therapy; reproductive phases