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Hepatitis C virus as a systemic disease: reaching beyond the liver
Kirat Gill1, Hasmik Ghazinian2,3, Richard Manch1
1Department of Internal Medicine, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Hepatology International
|December 15, 2015
Summary
Chronic hepatitis C (CHC) causes numerous extrahepatic manifestations, impacting over 40% of patients. These conditions, including diabetes and cardiovascular disease, significantly increase mortality risk from non-liver causes.
Area of Science:
- Hepatology and Viral Immunology
Background:
- Chronic hepatitis C (CHC) is a persistent viral infection with significant systemic implications.
- Extrahepatic manifestations (EHMs) are common, affecting 40-74% of CHC patients and sometimes presenting as the initial sign of infection.
Purpose of the Study:
- To elucidate the immunological and virological mechanisms underlying CHC-associated extrahepatic manifestations.
- To detail the spectrum of EHMs in CHC, including metabolic, cardiovascular, cerebrovascular, lymphoproliferative, renal, and cognitive disorders.
Main Methods:
- Review of immunological and virological pathways contributing to EHMs.
- Analysis of epidemiological data on the prevalence and impact of specific EHMs in CHC patients.
- Examination of renal pathology in CHC-associated mixed cryoglobulinemia.
Main Results:
- CHC is linked to a four-fold increased risk of insulin resistance, type 2 diabetes, and cardiovascular disease (17-37%).
- Increased cerebrovascular mortality correlates with viral load; lymphoproliferative disorders, particularly non-Hodgkin lymphoma, are associated.
- Renal involvement (35-60% of CHC-mixed cryoglobulinemia patients) often presents as glomerulonephritis, with varying degrees of renal dysfunction.
Conclusions:
- Extrahepatic manifestations of CHC are diverse, affecting multiple organ systems.
- These comorbidities contribute significantly to increased non-liver-related mortality in CHC patients.
- Understanding EHMs is crucial for comprehensive CHC patient management and prognosis.
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