Extrahepatic Manifestations of Chronic HCV Infection

The purpose of the article is a summary overview of approaches to the treatment of infection caused by hepatitis C virus (HCV) in children and adolescents. The article is devoted to issues affecting indications, contraindications and optimal treatment regimens in children and adolescents with chronic HCV infection.All over the world, 13.2 (11.5–21.2) million children aged 1–15 years have HCV. Chronic HCV infection in children, as a rule, is more lethargic than in adults; extrahepatic manifestations mainly in the form of subclinical hypothyroidism and autoimmune thyroiditis occur, respectively, in 11 and 5.6% of cases. The risk of developing liver cirrhosis in children with chronic HCV infection ranges from 1 to 4%, while bridging fibrosis and severe liver inflammation are described in approximately 15%. The article discusses the issues of therapy: goals, endpoints, indications, contraindications and the optimal treatment regimen in children with chronic HCV infection. The recommendations made by the European Society for Pediatric Gastroenterologists, Hepatologists and Nutritionists (ESPGHAN) are provided.Conclusion. Chronic HCV infection in children in general is in a benign form, but treatment of the disease is required to achieve success in eliminating hepatitis C.

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Chronic HCV infection: An internist’s opinion (Part 2)

Terapevticheskii arkhiv ◽

10.17116/terarkh20168811138-148 ◽

2016 ◽

Vol 88 (11) ◽

pp. 138-148

Author(s):

M L Zubkin ◽

V I Chervinko ◽

Yu V Ovchinnikov ◽

E V Kryukov ◽

O N Kotenko

Keyword(s):

Diabetes Mellitus ◽

Antiviral Agents ◽

Hcv Infection ◽

Cardiovascular Disorders ◽

Extrahepatic Manifestations ◽

Endocrine Diseases ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Relationship Of ◽

The Relationship

Hepatitis C virus (HCV) infection results in not only chronic hepatitis and subsequent complications as liver cirrhosis and hepatocellular carcinoma, but also in a significant number of other diseases, the so-called extrahepatic manifestations of chronic HCV infection. In addition to lymphoproliferative and autoimmune disorders discussed in Part 1 of this review, many other diseases turned to be associated with chronic HCV infection. Part 2 of this review is dedicated to the analysis of the relationship of chronic HCV-infection to the development of some endocrine diseases, such as thyroiditis and diabetes mellitus, and cardiovascular disorders. It also provides the characteristics of the currently available antiviral agents and considers whether they may be used in patents with extrahepatic manifestations of chronic HCV infection.

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Orbital Pseudotumor as an Extrahepatic Complication of Chronic HCV Infection

Case Reports in Infectious Diseases ◽

10.1155/2018/5498953 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Owen Huang ◽

Tina Shah ◽

Divya Sundarapandiyan ◽

Matthew J. Akiyama

Keyword(s):

Steroid Treatment ◽

Hcv Infection ◽

Surrounding Tissue ◽

Extrahepatic Manifestations ◽

Lacrimal Glands ◽

Orbital Pseudotumor ◽

Chronic Hcv Infection ◽

Chronic Hcv

We present a patient who was admitted for eye swelling, pain, and discharge, with CT orbits with contrast demonstrating inflammation and enlargement of the lacrimal glands and surrounding tissue. He was found to have an HCV infection for unknown duration upon further investigation. All other workup (autoimmune, rheumatic, and infectious) was unrevealing. The patient was diagnosed with orbital pseudotumor as an extrahepatic complication of chronic HCV infection, and he was managed with prednisone which dramatically decreased his eye swelling and pain. Steroid treatment may serve as a bridge to suppress symptoms of extrahepatic manifestations, especially in ocular cases, while HCV-infected patients await treatment to eradicate their HCV infection.

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Intrahepatic B cell clonal expansions and extrahepatic manifestations of chronic HCV infection

European Journal of Immunology ◽

10.1002/eji.200324328 ◽

2004 ◽

Vol 34 (1) ◽

pp. 126-136 ◽

Cited By ~ 76

Author(s):

Domenico Sansonno ◽

Gianfranco Lauletta ◽

Valli De Re ◽

Felicia Anna Tucci ◽

Pietro Gatti ◽

...

Keyword(s):

B Cell ◽

Hcv Infection ◽

Extrahepatic Manifestations ◽

Chronic Hcv Infection ◽

Chronic Hcv

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Extrahepatic Manifestations and Autoantibodies in Patients with Hepatitis C Virus Infection

Clinical and Developmental Immunology ◽

10.1155/2012/871401 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 41

Author(s):

Takashi Himoto ◽

Tsutomu Masaki

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hcv Infection ◽

Hepatitis C Virus Infection ◽

Extrahepatic Manifestations ◽

Autoimmune Thyroid ◽

Organ Specific ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

The Relationship

Patients with chronic hepatitis C virus (HCV) infection frequently have many extrahepatic manifestations, as persistent HCV infection often triggers lymphoproliferative disorders and metabolic abnormalities. These manifestations primarily include autoimmune disorders such as cryoglobulinemia, Sjögren’s syndrome, and autoimmune thyroid disorders. It has been well established that chronic HCV infection plays important roles in the production of non-organ-specific autoantibodies, including antinuclear antibodies and smooth muscle antibodies, and organ-specific autoantibodies such as thyroid autoantibodies. However, the clinical significance of autoantibodies associated with the extrahepatic manifestations caused by HCV infection has not been fully recognized. In this paper, we mainly focus on the relationship between extrahepatic manifestations and the emergence of autoantibodies in patients with HCV infection and discuss the clinical relevance of the autoantibodies in the extrahepatic disorders.

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A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy

Viruses ◽

10.3390/v13112249 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2249

Author(s):

Cesare Mazzaro ◽

Luca Quartuccio ◽

Luigi Elio Adinolfi ◽

Dario Roccatello ◽

Gabriele Pozzato ◽

...

Keyword(s):

Quality Of Life ◽

Hcv Infection ◽

Extrahepatic Manifestations ◽

Direct Acting Antiviral ◽

Chronic Hepatitis C Virus ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Direct Acting

Extrahepatic manifestations are a feature of chronic hepatitis C virus (HCV) infection. In the course of chronic HCV infection, about 70% of patients have one or more extrahepatic manifestations. The latter are often the first and only clinical sign of infection. Experimental and clinical data support a causal association for many extrahepatic manifestations and HCV infection, which include mixed cryoglobulinemia, non-Hodgkin lymphomas (NHL), cardiovascular disease, insulin resistance, type 2 diabetes, neurological and psychiatric disease and other rheumatic diseases. All these extrahepatic conditions influence the morbidity, quality of life and mortality of HCV-infected patients. Currently, interferon-free therapeutic regimens with direct-acting antiviral agents (DAA) offer the possibility of treatment to almost the entire infected population, irrespective of stage of cirrhosis and associated serious comorbidities, always maintaining a high efficacy and tolerability. Several studies have shown a close association between HCV clearance by DAAs and an improvement or reduction in the risk of extrahepatic manifestations. Patients with HCV after a sustained virologic response (SVR) by DAA treatment have a lower risk than non-responders of developing cryoglobulinemic vasculitis and B-cell non-Hodgkin’s lymphomas. Furthermore, the SVR by DAA also reduces the risk of acute coronary syndrome, cardiovascular disease, insulin resistance and type 2 diabetes, and it improves atherosclerosis. HCV clearance by DAA also improves the quality of life and survival of patients with chronic HCV infection with associated extrahepatic diseases. Thus, DAAs should be initiated as early as possible in HCV patients with extrahepatic manifestations.

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