重视慢性丙型肝炎合并其他系统疾病的诊治

Emphasis on diagnosis and treatment of chronic hepatitis C complicated with diseases of other systems

丙型肝炎病毒(hepatitis C virus,HCV)除感染肝脏外,还可以侵犯淋巴系统、肾脏、骨髓、甲状腺等多个组织和器官。因此,慢性丙型肝炎(chronic hepatitis C,CHC)患者在临床除了出现肝脏受损的表现外,还可以出现多器官受累的临床表现,如合并糖尿病、肾病、自身免疫性疾病、血液系统疾病等,使CHC的治疗变得比较复杂,特别是使用干扰素进行抗病毒治疗时,既要考虑药物的有效性,又要避免对其他伴随疾病的影响。本期笔谈结合最近的临床研究,对CHC患者合并上述其他内科疾病的临床特点、疾病间的相互影响以及治疗策略进行专题讨论,其目的是为了指导临床医生更好地认识和治疗CHC合并其他疾病的患者。

Hepatitis C virus（HCV） can be replicated in extra-hepatic cells, including lymph nodes, kidney, bone marrow and thyroid. HCV infection is associated with several extra-hepatic manifestations, as mixed cryoglobulinemia, lymphomas, rheumatic disorders, autoimmune thyroiditis, hypothyroidism, and type 2 diabetes. Successful eradication of HCV with interferon alfa and ribavirin was shown to improve some of these extra-hepatic effects and sustained virological response is associated with resolution of those complications. This chapter we will focus on the HCV infection and extra-hepatic manifestations in clinical features, interaction and treatment strategy.