Extrahepatic Manifestations of Hepatitis C Virus Infection

Abstract

Approximately 130–170 million people are infected with hepatitis C virus (HCV) worldwide and 2.35% of the total world population. HCV infection induces tremendous morbidity and mortality mainly due to liver complications (cirrhosis, hepatocellular carcinoma) and significant direct medical costs. In addition, HCV is associated to a large number of extrahepatic manifestations, including cardiovascular diseases, type 2 diabetes and insulin resistance, neurocognitive dysfunction, systemic vasculitis, B cell non-Hodgkin lymphoma and chronic kidney disease. The recent emergence of new direct acting interferon-free antivirals (DAA), enabling high cure rates with a good safety profile, should benefit also many patients presenting HCV extrahepatic complications. Multidisciplinary consensus recommends considering as first-line treatment IFN-free DAAs for HCV patients with significant liver fibrosis and extrahepatic complications.