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Hepatitis C virus‐related extra‐hepatic disease — aetiopathogenesis and management
Author(s) -
Medina J.,
GarcíaBuey L.,
MorenoOtero R.
Publication year - 2004
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/j.1365-2036.2004.01919.x
Subject(s) - medicine , immunology , porphyria cutanea tarda , lymphoproliferative disorders , hepatitis c virus , hepatitis c , autoimmune hepatitis , hepatitis , lymphoma , dermatology , virus
Summary Hepatitis C virus infection is often associated with extra‐hepatic manifestations, secondary to the elicitation of autoimmune reactions, generalized deposition of immune complexes and lymphoproliferative disorders. The most clearly established associations are those linking chronic hepatitis C with mixed cryoglobulinaemia (and the related glomerulonephritis and cutaneous vasculitis), as well as with the presence of autoantibodies. Less well‐documented disorders include non‐Hodgkin's lymphoma, thrombocytopenia, sialadenitis, thyroid disease, lichen planus, porphyria cutanea tarda, rheumatoid disorders and neurological disorders. Extra‐hepatic manifestations are most frequent in patients of female sex, advanced age, long‐lasting infection and cirrhosis. Optimal treatment strategies should be based on the predominant manifestation of the disease. In the case of autoimmune disorders not clearly attributable to the viral infection, corticosteroids may be the most effective option. Interferon‐α alone or in combination with ribavirin may be indicated for those disorders related to immune complex deposition, such as mixed cryoglobulinaemia, although relapses of extra‐hepatic signs often occur on discontinuation of treatment. In some cases, interferon‐α may induce or exacerbate some extra‐hepatic manifestations.