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Published on: June 26, 2020
[HCV and extrahepatic diseases]
M Durazzo1, G M Mariani, C Sacchi
1Dipartimento di Medicina Interna, Università degli Studi, Turin.
Insights
Hepatitis C virus (HCV) infection can cause immune system problems outside the liver. Antiviral therapy shows promise for treating some of these serious HCV-related autoimmune conditions.
Area of Science:
- Hepatology
- Immunology
- Virology
Context:
- Hepatitis C virus (HCV) is a significant cause of chronic hepatitis.
- HCV infection is associated with numerous extrahepatic immunological disorders.
- HCV's tropism extends to peripheral blood mononuclear cells, including lymphocytes and monocytes.
Purpose:
- To review the spectrum of extrahepatic manifestations linked to HCV infection.
- To explore the pathogenetic role of HCV in autoimmunity.
- To discuss the therapeutic implications of antiviral and interferon therapies for HCV-associated conditions.
Summary:
- HCV infection is implicated in a wide array of autoimmune conditions beyond the liver.
- The virus's ability to infect immune cells provides insight into HCV-associated autoimmunity.
- Clinical guidelines recommend screening for HCV in patients with extrahepatic disorders and vice versa.
Impact:
- Antiviral therapy is effective for specific HCV-related extrahepatic diseases like mixed cryoglobulinemia and glomerulonephritis.
- Understanding HCV's role in autoimmunity guides clinical management and therapeutic strategies.
- This review highlights the importance of considering HCV in the differential diagnosis of autoimmune diseases.
Abstract:
Besides being a hepatotropic virus and a common cause of chronic hepatitis, hepatitis C virus (HCV) has been linked to a variety of extrahepatic immunological manifestations. The high prevalence of HCV infections in some of these conditions suggests an important pathogenetic role of the virus. The recent observation that HCV infects peripheral blood mononuclear cells, such as CD8+ T lymphocytes, CD19+ B lymphocytes and monocytes/microphages, has given an insight into the possible mechanisms of HCV associated autoimmunity. In the clinical practice it is recommended not only to search for symptoms and signs of autoimmune disorders in patients with chronic hepatitis C, but also to test for hepatitis C virus infection patients with extrahepatic conditions known to be related to HCV. Even if the occurrence of autoimmune disorders or the exacerbations of autoimmune diseases has been reported during interferon therapy, antiviral therapy is effective in treating some of the extrahepatic disorders associated with HCV, namely mixed cryoglobulinemia and membranoproliferative glomerulonephritis. The extrahepatic manifestations associated with hepatitis C virus infection are reviewed according to the available data and the option of interferon therapy is discussed.
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