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Impact of hepatitis C virus therapy on metabolism and public health
Author(s) -
Shiffman Mitchell L.,
Gunn Nadege T.
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13282
Subject(s) - medicine , metabolic syndrome , steatosis , cirrhosis , hepatitis c virus , kidney disease , hepatocellular carcinoma , diabetes mellitus , insulin resistance , gastroenterology , fatty liver , chronic liver disease , disease , immunology , virus , insulin , obesity , endocrinology
Chronic hepatitis C virus ( HCV ) is associated with insulin resistance ( IR ) and leads to type 2 diabetes mellitus (T2 DM ) and hepatic steatosis in many patients. These metabolic complications of HCV have been shown to accelerate the progression of fibrosis to cirrhosis and increase the risk of hepatocellular carcinoma. The metabolic syndrome is a common disorder that also includes IR , T2 DM and hepatic steatosis. Approximately 20%‐30% of patients with chronic HCV also have co‐existent metabolic syndrome. The cause of steatosis in patients with the features of both the metabolic syndrome and chronic HCV is sometime difficult to determine. Patients with metabolic syndrome and chronic HCV are also at risk of developing renal, cardiovascular and cerebrovascular disease. Recent data suggest that HCV is an independent risk factor for renal, coronary and cerebral vascular disease, and may increase mortality associated with these disorders. The treatment of HCV can now result in a sustained virological response and cure nearly all patients with chronic HCV . The eradication of HCV reduces the risk of developing IR and T2 DM , improves IR and 2 TDM , reduces the risk of developing chronic kidney disease, end‐stage renal disease, acute cardiac syndrome and stroke in patients with 2 TDM . Thus, treatment of chronic HCV can provide a significant public health benefit, but only if all patients with chronic HCV are identified and universally treated.