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Systematic review with meta‐analysis: extrahepatic manifestations in chronic hepatitis C virus‐infected patients in East Asia
Author(s) -
Younossi Zobair M.,
Henry Linda,
P. Ong Janus,
Tanaka Atsushi,
Eguchi Yuichiro,
Mizokami Masashi,
Lim YoungSuk,
Dan Yock Young,
Yu MingLung,
Stepanova Maria
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15131
Subject(s) - medicine , odds ratio , meta analysis , confidence interval , hepatitis c virus , chronic liver disease , diabetes mellitus , gastroenterology , cirrhosis , virus , immunology , endocrinology
SUMMARY Background Although the prevalence of extrahepatic manifestations of chronic hepatitis C virus ( HCV ) infection has been reported from Western countries, their prevalence in East Asian countries is not well known. Aim To perform a systematic review to quantify the prevalence of selected extrahepatic manifestations of HCV among patients from East Asia. Methods Medline, CINAHL , EMBASE , Cochrane and country‐specific databases were reviewed according to standard guidelines for meta‐analyses. Only articles with patients from East Asian countries were included. Results After review, 34 articles were selected (Japan = 9; China = 5, Korea = 3, Taiwan = 16, multiple countries = 1) with 646 228 subjects, 66 436 with HCV . Mean age for HCV ‐infected patients was 56 years (range 41‐72 years), 50% were male (range 26%‐73%). The pooled prevalence of type 2 diabetes in East Asian HCV patients was 19.0% (95% confidence interval 15.6%‐22.9%) (n = 19 studies) with an increased risk when compared to non‐ HCV : odds ratio ( OR ) 1.58 (1.28‐1.94). The prevalence of chronic kidney disease in HCV was 9.2% (5.0%‐16.2%) (n = 7 studies), also with a significantly increased risk: OR =1.98 (1.41‐2.77). Pooled prevalence of cardiovascular disease in HCV was 8.6% (3.5%‐19.9%) (n = 6 studies), also with an increased risk: OR = 1.55 (1.21‐1.98). The prevalence of lichen planus in HCV was 8.9% (3.6%‐20.6%) (n = 6 studies) while the prevalence of rheumatoid arthritis was 4.5% (0.6%‐25.7%) (n = 4 studies). Conclusions These data show increased risk of developing extrahepatic manifestations in East Asian patients with HCV . Both hepatic and extrahepatic manifestations of the infection should be used to accurately determine the total burden of the disease in the region.