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:	Cesare Mazzaro, Luca Quartuccio, Luigi Elio Adinolfi, Dario Roccatello, Gabriele Pozzato, Riccardo Nevola, Maurizio Tonizzo, Stefano Gitto, Pietro Andreone, Valter Gattei
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cryoglobulinemia direct-acting antivirals (DAAs) hepatitis C virus purpura arthralgia Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/6c19cf3b456e43b984b8487e5e80dc33
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spelling	oai:doaj.org-article:6c19cf3b456e43b984b8487e5e80dc332021-11-25T19:13:45ZA Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy10.3390/v131122491999-4915https://doaj.org/article/6c19cf3b456e43b984b8487e5e80dc332021-11-01T00:00:00Zhttps://www.mdpi.com/1999-4915/13/11/2249https://doaj.org/toc/1999-4915Extrahepatic 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.Cesare MazzaroLuca QuartuccioLuigi Elio AdinolfiDario RoccatelloGabriele PozzatoRiccardo NevolaMaurizio TonizzoStefano GittoPietro AndreoneValter GatteiMDPI AGarticlecryoglobulinemiadirect-acting antivirals (DAAs)hepatitis C viruspurpuraarthralgiaMicrobiologyQR1-502ENViruses, Vol 13, Iss 2249, p 2249 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cryoglobulinemia direct-acting antivirals (DAAs) hepatitis C virus purpura arthralgia Microbiology QR1-502
spellingShingle	cryoglobulinemia direct-acting antivirals (DAAs) hepatitis C virus purpura arthralgia Microbiology QR1-502 Cesare Mazzaro Luca Quartuccio Luigi Elio Adinolfi Dario Roccatello Gabriele Pozzato Riccardo Nevola Maurizio Tonizzo Stefano Gitto Pietro Andreone Valter Gattei A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy
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.
format	article
author	Cesare Mazzaro Luca Quartuccio Luigi Elio Adinolfi Dario Roccatello Gabriele Pozzato Riccardo Nevola Maurizio Tonizzo Stefano Gitto Pietro Andreone Valter Gattei
author_facet	Cesare Mazzaro Luca Quartuccio Luigi Elio Adinolfi Dario Roccatello Gabriele Pozzato Riccardo Nevola Maurizio Tonizzo Stefano Gitto Pietro Andreone Valter Gattei
author_sort	Cesare Mazzaro
title	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_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_sort	review on extrahepatic manifestations of chronic hepatitis c virus infection and the impact of direct-acting antiviral therapy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/6c19cf3b456e43b984b8487e5e80dc33
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A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy

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