The association between chronic hepatitis C(CHC)infection and extrahepatic manifestations(EHMs),particularly cardiometabolic diseases,has been extensively examined.However,there has still been insufficient evaluation ...The association between chronic hepatitis C(CHC)infection and extrahepatic manifestations(EHMs),particularly cardiometabolic diseases,has been extensively examined.However,there has still been insufficient evaluation for these EHMs after virological cure.Several multidirectional mechanisms have been proposed explaining the ability of hepatitis C virus(HCV)developing EHMs,cardiometabolic ones,as well as the effect of antiviral therapy to resolve these EHMs.Data on these manifestations after achieving sustained virologic response(SVR)are still conflicting.However,current evidence suggests that reversal of hepatic steatosis and its coexistent hypocholesterolemia after successful viral eradication led to unfavorable lipid profile,which increases cardiovascular disease(CVD)risk.Additionally,most observations showed that metabolic alterations,such as insulin resistance and diabetes mellitus(DM),undergo some degree of reduction after viral clearance.These changes seem HCV-genotype dependent.Interferon-based antiviral therapy and direct acting antiviral drugs were shown to minimize incidence of DM.Large epidemiological studies that investigated the effect of SVR on CVD showed great discrepancies in terms of results,with predominant findings indicating that CVD events decreased in patients with SVR compared to non-responders or untreated ones.In this review,we present a summary of the current knowledge regarding extrahepatic sequelae of CHC following SVR,which may have an impact on healthcare providers’clinical practice.展开更多
基金Junior 1 and 2 Salary Award from Fonds de la Recherche en Santédu Québec,No.27127Junior 1 and 2 Salary Award from Fonds de la Recherche en Santédu Québec,No.267806+1 种基金Research Salary from the Department of Medicine of McGill UniversityPfizer via Unrestricted Educational Grant.
文摘The association between chronic hepatitis C(CHC)infection and extrahepatic manifestations(EHMs),particularly cardiometabolic diseases,has been extensively examined.However,there has still been insufficient evaluation for these EHMs after virological cure.Several multidirectional mechanisms have been proposed explaining the ability of hepatitis C virus(HCV)developing EHMs,cardiometabolic ones,as well as the effect of antiviral therapy to resolve these EHMs.Data on these manifestations after achieving sustained virologic response(SVR)are still conflicting.However,current evidence suggests that reversal of hepatic steatosis and its coexistent hypocholesterolemia after successful viral eradication led to unfavorable lipid profile,which increases cardiovascular disease(CVD)risk.Additionally,most observations showed that metabolic alterations,such as insulin resistance and diabetes mellitus(DM),undergo some degree of reduction after viral clearance.These changes seem HCV-genotype dependent.Interferon-based antiviral therapy and direct acting antiviral drugs were shown to minimize incidence of DM.Large epidemiological studies that investigated the effect of SVR on CVD showed great discrepancies in terms of results,with predominant findings indicating that CVD events decreased in patients with SVR compared to non-responders or untreated ones.In this review,we present a summary of the current knowledge regarding extrahepatic sequelae of CHC following SVR,which may have an impact on healthcare providers’clinical practice.
