scholarly journals Tubular cell damage may be the earliest sign of renal extrahepatic manifestation caused by Hepatitis C

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251392
Author(s):  
Kati Kaartinen ◽  
Sauli Vuoti ◽  
Eero Honkanen ◽  
Eliisa Löyttyniemi ◽  
Ravinder Singh ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Cell Damage ◽  
Tubular Cell ◽  
Extrahepatic Manifestations ◽  
Hepatitis C Infection ◽  
Renal Manifestation ◽  
Standard Clinical Practice ◽  
Tubulointerstitial Damage ◽  
Duration Of Infection ◽  
Chronic Hcv

Chronic kidney disease (CKD) is one of the most well-known extrahepatic manifestations caused by hepatitis C infection (HCV). CKD is typically discovered at a late stage. HCV-nephropathy may show different histopathologic patterns, as both glomerular and tubulointerstitial damage have been described. Identification of patients with early renal manifestations would be beneficial to provide treatment and avoid progression to CKD. The observational prospective single-center HCVKID study assessed the prevalence of early renal manifestations in patients with chronic HCV and compared these patients with HCV-negative healthy controls cross-sectionally. HCV-positive patients with and without renal manifestations were also compared to define biomarkers suitable for identifying early manifestations in standard clinical practice. Tubular proteinuria as judged by urine α 1-microglobulin was the most common early renal manifestation found in 11% in HCV-positive patients, followed by hematuria in 8%. Kidney filtration was statistically significantly lower among HCV-positive patients with renal manifestation according to any calculation method. There were no significant differences in duration of infection or stage of liver fibrosis between patients with or without renal manifestations. Tubular cell damage may be the earliest sign of renal dysfunction caused by HCV. Complement activation also correlates with the dysfunction, indicating of contribution to HCV-induced renal manifestations even in their early phase.

scholarly journals Orbital Pseudotumor as a Rare Extrahepatic Manifestation of Hepatitis C Infection

2016 ◽  
Vol 10 (1) ◽  
pp. 113-119 ◽  
Author(s):  
Benjamin Misselwitz ◽  
Jana Epprecht ◽  
Joachim Mertens ◽  
Luc Biedermann ◽  
Michael Scharl ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Cavernous Sinus ◽  
Lymphocytic Infiltrate ◽  
Sensory Loss ◽  
Extrahepatic Manifestations ◽  
Orbital Pseudotumor ◽  
Hepatitis C Infection ◽  
Vestibulocochlear Nerve ◽  
Long Term Follow Up ◽  
Chronic Hcv

Hepatitis C is frequently accompanied by immune-related extrahepatic manifestations affecting the skin, kidneys, central and peripheral nervous system and exocrine glands. We present the case of a 40-year-old man with left-sided ptosis, exophthalmos and headache. MRI demonstrated left-sided orbital pseudotumor with lacrimal and retro-orbital contrast enhancement extending to the cavernous sinus and the vestibulocochlear nerve. Immunological tests of serum and cerebrospinal fluid identified hepatitis C virus (HCV) as a potential causative agent but did not indicate any additional infectious, malignant or immunological disorder. Hepatological evaluation revealed no signs of advanced liver disease. After initial spontaneous improvement, the patient subsequently developed vestibulocochlear failure with gait disorder, tinnitus and transient left-parietal sensory loss. Lacrimal biopsy demonstrated lymphocytic infiltrate, prompting steroid treatment. After initial improvement, steroids could not be tapered below 40 mg daily for several months due to recurrent symptoms. Twelve months after the initial presentation, the patient’s chronic HCV infection was successfully treated with sofosbuvir, simeprevir and ribavirin and he remains now free of symptoms without steroids. In patients with chronic hepatitis C, lymphocytic infiltrate of the salivary and lacrimal glands is a frequent phenomenon. However, the extent of the lymphocytic infiltrate beyond the lacrimal gland to the tip of the orbit, cavernous sinus and vestibulocochlear nerve as in our patient is highly unusual. For all symptomatic extrahepatic manifestations of hepatitis C infection, treatment of HCV as the underlying immune stimulus is recommended, and it helped to control the symptoms in our patient. In addition, long-term follow-up for recurrent lymphocyte infiltrate and development of lymphoma is warranted.

Treatment of acute hepatitis C infection with interferon-alfa 2b monotherapy prevents development of chronic HCV infection

2001 ◽  
Vol 120 (5) ◽  
pp. A567-A567 ◽  
Author(s):  
E JAECKEL ◽  
M CORNBERG ◽  
T SANTANTONIO ◽  
J MAYER ◽  
H WEDEMEYER ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Acute Hepatitis ◽  
Interferon Alfa ◽  
Hcv Infection ◽  
Acute Hepatitis C ◽  
Hepatitis C Infection ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

scholarly journals Spontaneous Clearance of Chronic HCV: The Key Ending Left in the Dark

2019 ◽  
Vol 7 (10) ◽  
pp. 1657-1659
Author(s):  
Nikola Hristov Mumdzhiev ◽  
Daniela Valerieva Radicheva ◽  
Mariana Penkova Radicheva ◽  
Rumen Valchev Tenev ◽  
Zlatina Dimitrova Vasileva
Keyword(s):  
Hepatitis C ◽  
Hcv Rna ◽  
Spontaneous Clearance ◽  
Hepatitis C Infection ◽  
Positive Serology ◽  
Mild Disease ◽  
Spontaneous Hcv Clearance ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Special Circumstances

BACKGROUND: Hepatitis C is the second leading cause of liver cirrhosis and hepatocellular carcinoma. Although the discovery of direct-acting agents made the disease curable, HCV elimination can be achieved solely by the host’s immunologic arsenal. CASE REPORT: We report the case of a 29-year-old woman with chronic hepatitis C infection - elevated transaminases, positive serology. HCV was detectable on two occasions, and histology showed mild disease - A1F1. Upon follow up and without any treatment, the patient achieved spontaneous clearance confirmed by two consecutive undetectable HCV RNA tests. Spontaneous HCV clearance rarely occurs – 0.5% per person-year. This is sometimes accompanied by special circumstances like additional disease or medical interventions. Host factors like gender and interleukin-28B polymorphisms have been known to contribute to clearance. Viral factors like HCV RNA levels are also a factor. The characteristics of host-viral interplay – age of acquisition and fibrosis stage – cannot be overlooked. CONCLUSION: All of the abovementioned factors contribute to the complex immunological interaction between virus and host and the result, although rarely can be spontaneous clearance.

scholarly journals 293. Hepatitis C is now a Millennial Disease in Response to the Opioid Crisis: A Demographic Shift in Hepatitis C Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S159-S159
Author(s):  
Michelle Rose ◽  
John Allen Myers ◽  
Nicholas Ryan ◽  
Alissa Prince ◽  
Morgan Talbot ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Baby Boomers ◽  
Infected Individual ◽  
The United States ◽  
Hcv Infection ◽  
Demographic Shift ◽  
Hepatitis C Infection ◽  
Opioid Crisis ◽  
Chronic Hcv ◽  
Over Time

Abstract Background Previous research has shown millennials represent the fastest growing generation for those infected with the hepatitis C virus (HCV). Millennials are also a key driver in the opioid crisis, particularly in states of the Appalachian region including Kentucky. Despite research demonstrating a change in prevalence from baby boomers (born 1945–1965) to millennials (born 1980–1995), large representative studies providing evidence of the magnitude of this demographic shift are lacking in the United States. Our objective was to assess trends of HCV infection since 2016 in a large healthcare system located in an area of high prevalence of opioid use and HCV infection. Methods All individuals were screened for HCV infection in 2016, 2017, and 2018 within Norton Healthcare per standard risk-based criteria (e.g., injection drug users, baby boomers, etc.) as recommended by CDC, except for pregnant women who were universally screened since 2016. We tested for demographic shifts over time using longitudinal and time series analyses techniques Results A total of 86,243 individuals were screened for HCV infection from 2016 to 2018. Of those, 2,615 (3.0%) individuals screened positive for chronic HCV. The average age of those infected significantly decreased by an average of 3.7 years annually (from 47.3 years in 2016 to 39.9 years in 2018, P < 0.001). We forecast a plateau near the age of 28 years will be observed in just over 7 years. In addition, the proportion of millennials increased over time (33.6% in 2016, 42.4% in 2017 and 51.4% in 2018, P < 0.001), while baby boomers significantly decreased over time (44.0% in 2016, 38.8% in 2017, and 29.3% in 2018, P < 0.001). Lastly, over time, those with chronic HCV were more likely to be male (increasing from 49.6% to 54.4%, P = 0.008) and Hispanic (increasing from 1.6% to 17.7%, P < 0.001) Conclusion Our results suggest that HCV infection has become a predominately millennial disease, skipping a generation. These results correlate with trends seen with the opioid epidemic, which is driven by millennials. We conclude that the opioid crisis has led to a drastic demographic shift, and currently the typical HCV-infected individual is a younger male. Without interventions, this trend will continue for over seven years, plateauing near the demarcation of millennials and generation Z Disclosures All authors: No reported disclosures.

scholarly journals Extrahepatic manifestations of chronic hepatitis C infection: a consecutive study in Brazilian patients

2017 ◽  
Vol 21 (2) ◽  
pp. 203-204 ◽  
Author(s):  
Fátima M. Tengan ◽  
Mauricio Levy-Neto ◽  
Ivan D. Miziara ◽  
Bianca P. Dantas ◽  
Luciana Maragno
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Extrahepatic Manifestations ◽  
Hepatitis C Infection

scholarly journals Hepatitis C virus and myocardial dysfunction – possible association

2016 ◽  
Vol 63 (2) ◽  
pp. 123-127
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Myocardial Dysfunction ◽  
Special Importance ◽  
Imaging Data ◽  
Extrahepatic Manifestations ◽  
Myocardial Disease ◽  
Chronic Hcv Infection ◽  
Extrahepatic Tissues ◽  
Chronic Hcv

Hepatitis C virus (HCV) is a virus known to infect the liver. In last years, accumulated evidences has demonstrate the presence and active HCV replication in extrahepatic tissues. There are currently epidemiological, clinical, immunohistochemical and imaging data suggesting involvement of HCV in myocardial disease. The recognition of myocardial dysfunction as extrahepatic manifestations of chronic HCV infection is of special importance with significant clinical and therapeutical impact.

scholarly journals Interferon treatment for chronic hepatitis C infection in hemophiliacs-- influence of virus load, genotype, and liver pathology on response

Blood ◽  
1996 ◽  
Vol 87 (5) ◽  
pp. 1704-1709 ◽  
Author(s):  
JP Hanley ◽  
LM Jarvis ◽  
J Andrew ◽  
R Dennis ◽  
PC Hayes ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Early Stage ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Interferon Treatment ◽  
Hepatitis C Infection ◽  
Virus Load ◽  
Chronic Hcv

In this study, we assessed the effectiveness of interferon treatment in 31 hemophiliacs with chronic hepatitis C virus (HCV) infection. Interferon alfa-2a (3 MU three times weekly) was administered for 6 months. Response was assessed by both serial alanine transaminase (ALT) and HCV RNA levels measured by a sensitive semiquantitative polymerase chain reaction (PCR) method. HCV genotype was determined by restriction fragment length polymorphism (RFLP), and evidence of changing genotypes during interferon therapy was sought. Severity of liver disease was assessed by both noninvasive and invasive methods, including laparoscopic liver inspection and biopsy. Sustained normalization of ALT levels occurred in eight patients (28%), and seven (24%) became nonviremic as assessed by PCR (<80 HCV/mL). Responders universally cleared HCV RNA within 2 months of starting interferon. Genotype 3a was associated with a favorable response to interferon. No evidence was found for a change in circulating genotype in patients who failed to respond to interferon or who relapsed. This study confirms that response rates to interferon are low in hemophiliacs as compared with other groups with chronic HCV infection. We have also demonstrated that virus load measurement over the first 8 to 12 weeks of treatment is an extremely useful method to identify responders at an early stage.

scholarly journals Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

2018 ◽  
Author(s):  
Jessica Williams-Nguyen ◽  
Stephen E Hawes ◽  
Robin M Nance ◽  
Sara Lindström ◽  
Susan R Heckbert ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
The United States ◽  
Hcv Rna ◽  
High Risk Population ◽  
People Living With Hiv ◽  
Extrahepatic Manifestations ◽  
Chronic Hcv ◽  
Living With Hiv

AbstractHepatitis C virus (HCV) is common among people living with HIV (PLWH). The potential for extrahepatic manifestations of HCV, including myocardial infarction (MI), is a topic of active research. MI is classified into types, predominantly atheroembolic Type 1 MI (T1MI) and supply-demand mismatch Type 2 MI (T2MI). We examined the association between HCV and MI in the CFAR Network of Integrated Clinical Systems (CNICS), a multi-center clinical cohort of PLWH. MIs were centrally adjudicated and categorized by type using the Universal MI definition. We estimated the association between chronic HCV (RNA+) and time to MI adjusting for demographic characteristics, cardiovascular risk factors, clinical characteristics and substance use. Among 24,755 PLWH aged ≥18, there were 336 T1MI and 330 T2MI during a median of 4.2 years of follow-up. HCV was associated with a 68% greater risk of T2MI (adjusted hazard ratio (aHR) 1.68, 95% CI: 1.22, 2.30) but not T1MI (aHR 0.96, 95% CI: 0.63, 1.45). In a cause-specific analysis of T2MI, HCV was associated with a 2-fold greater risk of T2MI attributed to sepsis (aHR 2.26, 95% CI: 1.34, 3.81). Extrahepatic manifestations of HCV in this high-risk population are an important area for continued research.

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