title: Extrahepatic manifestations in chronic hepatitis C virus carriers.
abstract: Patients with chronic hepatitis C virus (HCV) infection frequently present with extrahepatic manifestations covering a large spectrum, involving different organ systems leading to the concept of systemic HCV infection. These manifestations include autoimmune phenomena and frank autoimmune and/or rheumatic diseases and may dominate the course of chronic HCV infection. Chronic HCV infection causes liver inflammation affecting the development of hepatic diseases. HCV is also a lymphotropic virus that triggers B cells and promotes favorable conditions for B lymphocyte proliferation, including mixed cryoglobulinemia (MC) and MC vasculitis, which is the most prominent extrahepatic manifestation of chronic HCV infection. HCV may also promote a low-grade chronic systemic inflammation that may affect the development of some extrahepatic manifestations, particularly cardiovascular and cerebral vascular diseases. Recognition of extrahepatic symptoms of HCV infection could facilitate early diagnosis and treatment. The development of direct-acting antiviral agents (DDAs) has revolutionized HCV treatment. DDAs, as well as new B-cell-depleting or B-cell-modulating monoclonal antibodies, will expand the panorama of treatment options for HCV-related extrahepatic manifestations including cryoglobulinemic vasculitis. In this context, a proactive, integrated approach to HCV therapy should maximize the benefits of HCV therapy, even when liver disease is mild.
authors: Service de Médecine Interne, Hôpital de l'Archet, CHU de Nice, Nice; Université de Nice-Sophia Antipolis, Nice, France COREVIH PACA EST, CHU de Nice, France rosenthal.e@chu-nice.fr.
authors: E
authors: E
authors: Rosenthal
authors: Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France INSERM, UMR_S 959, Paris, France CNRS, FRE3632, Paris, France AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France.
authors: P
authors: P
authors: Cacoub
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology; D003449:Cryoglobulinemia / Q000209:etiology; D003863:Depression / Q000150:complications; D044882:Glucose Metabolism Disorders / Q000209:etiology; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D008223:Lymphoma / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D012216:Rheumatic Diseases / Q000209:etiology; D014657:Vasculitis / Q000209:etiology
chemical_list: D000998:Antiviral Agents
keywords: Hepatitis C virus; cryoglobulinemia; extrahepatic manifestations; vasculitis