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[Extrahepatic manifestations of HCV infection]
1Scuola di Specializzatione in Reumatologia, Università degli Studi, Padova.
Insights
Hepatitis C virus (HCV) replicates beyond the liver, causing systemic immune-mediated issues. This review details HCV
Area of Science:
- Virology and Immunology
- Hepatology
- Systemic Manifestations of Viral Infections
Context:
- Chronic hepatitis C virus (HCV) infection is associated with systemic involvement.
- HCV replication occurs not only in the liver but also in extra-hepatic sites like blood mononuclear cells.
- Immune-mediated mechanisms are implicated in the systemic manifestations of chronic HCV.
Purpose:
- To review and classify the extra-hepatic manifestations of HCV infection.
- To highlight the causative role of HCV in specific clinical disorders.
- To discuss diagnostic challenges of HCV infection in autoimmune diseases.
Summary:
- HCV infection leads to various extra-hepatic syndromes, including dermatological, hematological, rheumatological, endocrinological, ophthalmological, and respiratory conditions.
- HCV is causally linked to mixed cryoglobulinemia and porphyria cutanea tarda, with high anti-HCV seroprevalence.
- Diagnostic difficulties arise in autoimmune diseases like Sjogren's syndrome due to hypergammaglobulinemia interfering with anti-HCV tests.
Impact:
- Provides a comprehensive classification of HCV-related extra-hepatic manifestations.
- Emphasizes the importance of considering HCV in the differential diagnosis of certain systemic and autoimmune diseases.
- Highlights challenges in HCV diagnosis within specific patient populations, prompting further research into diagnostic strategies.
Abstract:
It is well known that hepatitis C virus (HCV) can replicate outside the liver, particularly in the blood mononuclear cells. This fact may account for the systemic involvement, primarily due to immune-mediated mechanisms, which is commonly observed in patients affected with chronic hepatitis C. In this review the main extra-hepatic manifestations of the HCV infection are described and classified, according to the clinical involvement, namely dermatological, haematological, rheumatological, endocrinological, ophthalmological ad respiratory syndromes. In particular, the well-established causative role of HCV in determining certain clinical disorders, i.e., mixed cryoglobulinaemia and porphyria cutanea tarda, where the anti-HCV seroprevalence is higher than 70%, is emphasized. Moreover, some problems relevant to the diagnosis of the HCV infection in a proportion of autoimmune diseases (for example, primary Sjogren's syndrome), are discussed. Indeed, in these clinical disorders, hypergammaglobulinaemia, which represents an interfering factor with the results obtained by the screening anti-HCV tests, is a typical serologic feature.