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

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 suppo...

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Autores principales: Mazzaro, Cesare, Quartuccio, Luca, Adinolfi, Luigi Elio, Roccatello, Dario, Pozzato, Gabriele, Nevola, Riccardo, Tonizzo, Maurizio, Gitto, Stefano, Andreone, Pietro, Gattei, Valter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8619859/
https://www.ncbi.nlm.nih.gov/pubmed/34835054
http://dx.doi.org/10.3390/v13112249
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author Mazzaro, Cesare
Quartuccio, Luca
Adinolfi, Luigi Elio
Roccatello, Dario
Pozzato, Gabriele
Nevola, Riccardo
Tonizzo, Maurizio
Gitto, Stefano
Andreone, Pietro
Gattei, Valter
author_facet Mazzaro, Cesare
Quartuccio, Luca
Adinolfi, Luigi Elio
Roccatello, Dario
Pozzato, Gabriele
Nevola, Riccardo
Tonizzo, Maurizio
Gitto, Stefano
Andreone, Pietro
Gattei, Valter
author_sort Mazzaro, Cesare
collection PubMed
description 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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spelling pubmed-86198592021-11-27 A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy Mazzaro, Cesare Quartuccio, Luca Adinolfi, Luigi Elio Roccatello, Dario Pozzato, Gabriele Nevola, Riccardo Tonizzo, Maurizio Gitto, Stefano Andreone, Pietro Gattei, Valter Viruses Review 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. MDPI 2021-11-09 /pmc/articles/PMC8619859/ /pubmed/34835054 http://dx.doi.org/10.3390/v13112249 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mazzaro, Cesare
Quartuccio, Luca
Adinolfi, Luigi Elio
Roccatello, Dario
Pozzato, Gabriele
Nevola, Riccardo
Tonizzo, Maurizio
Gitto, Stefano
Andreone, Pietro
Gattei, Valter
A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
title A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
title_full A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
title_fullStr A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
title_full_unstemmed A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
title_short A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
title_sort review on extrahepatic manifestations of chronic hepatitis c virus infection and the impact of direct-acting antiviral therapy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8619859/
https://www.ncbi.nlm.nih.gov/pubmed/34835054
http://dx.doi.org/10.3390/v13112249
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