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Rheumatic manifestations of hepatitis C infection
Dimitrios Vassilopoulos1, Leonard H Calabrese
1Department of Rheumatic and Immunologic Diseases, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. calabrl@ccf.org
Insights
Hepatitis C virus (HCV) infection is linked to various rheumatic conditions. New HCV treatments may offer a chance to cure these associated symptoms by eradicating the virus.
Area of Science:
- Rheumatology
- Hepatology
- Immunology
Background:
- Hepatitis C virus (HCV) infection is uniquely associated with rheumatic manifestations and autoimmune findings.
- These include arthralgias, arthritis, fatigue, fibromyalgia, vasculitis, and Sjögren-like sialadenitis.
- Pathogenesis of these manifestations remains unclear, posing diagnostic and therapeutic challenges, especially with immunosuppressive therapy needs.
Purpose of the Study:
- To review recent advances in the epidemiology, pathogenesis, clinical findings, and treatment of HCV-associated rheumatic conditions.
Main Methods:
- This is a review article.
- It synthesizes recent findings on HCV-associated rheumatic conditions.
Main Results:
- HCV infection presents with diverse rheumatic symptoms.
- Diagnostic and therapeutic strategies are complicated by the chronic viral infection.
- Emerging HCV treatments offer potential for viral eradication and cure of associated conditions.
Conclusions:
- HCV-associated rheumatic conditions require careful management.
- Eradication of HCV may lead to resolution of these manifestations.
- Further research into pathogenesis and treatment is warranted.
Abstract:
Among chronic viral infections, hepatitis C virus (HCV) infection is uniquely associated with an array of rheumatic manifestations and autoimmune laboratory findings. These include, among others, arthralgias, arthritis, fatigue, fibromyalgia, vasculitis, and sialadenitis (Sjögren-like). The mechanisms that are involved in the pathogenesis of these diverse manifestations have not yet been clarified. Regardless of the direct or indirect pathogenetic role of HCV in these clinical entities, the concomitant presence of a chronic viral infection creates a number of diagnostic and therapeutic problems. This is particularly true when immunosuppressive therapy is needed for control of disease activity (eg, HCV-associated cryoglobulinemic vasculitis). The emerging treatment options for chronic HCV offer a major chance for viral eradication and conceivably for cure of these HCV-associated conditions. In this review, the recent advances in the epidemiology, pathogenesis, clinical findings, and treatment of HCV-associated rheumatic conditions are presented.