Endocrine manifestations of chronic HCV infection.
Chronic hepatitis C virus (HCV) infection has been associated with a great number of extra-hepatic manifestations (EHMs), including several endocrine disorders. Currently available epidemiological, clinical and experimental data do not show a link between HCV and all EHMs. Thyroid disorders (TD) and type 2 diabetes, for example, are the most frequent endocrine alterations in patients with chronic HCV infection, but there are only weak evidences that HCV could be involved in hypothalamic-pituitary axis perturbation, bone metabolism alteration and sexual dysfunctions induction. Thus, this issue needs further investigation. Prospective studies have also shown that interferon (IFN)-based therapy for chronic HCV infection can induce or worsen EHMs. In particular, IFN has been associated with development of autoimmunity and/or TD in up to 40% of chronic HCV infected patients. Hence, a careful monitoring of thyroid function should be performed in such patients. The recent approval of direct-acting antiviral agents in IFN-free regimens for chronic hepatitis C treatment will dramatically reduce not only liver-related mortality but also morbidity due to EHMs.
Department of Medical Sciences, University of Turin, Turin, Italy - caviglia.giampi@libero.it.
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Caviglia
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Rosso
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Fagoonee
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Cisarò
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Andrealli
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Pellicano
D004700:Endocrine System Diseases / Q000209:etiology* / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans