Hepatitis C cure with antiviral therapy--benefits beyond the liver

Antivir Ther. 2016;21(1):1-8. doi: 10.3851/IMP2975. Epub 2015 Jun 25.

Abstract

Liver disease is the major complication of chronic HCV infection. However, extrahepatic complications are common (50-75%), including mixed cryoglobulinaemia and B-cell lymphomas. Given that chronic hepatitis C has become curable using expensive oral direct-acting antivirals (DAAs), it seems worth revisiting the whole spectrum and burden of disease in HCV carriers.Herein, we update the most clinically significant medical complications associated with chronic hepatitis C and the evidence of benefits that would derive from a wide use of curative DAA therapies.Chronic HCV infection is associated with a broad spectrum of clinical conditions, including distinct rheumatic disorders (polyarthritis, sicca syndrome), lymphoproliferative conditions (mixed cryoglobulinaemia, monoclonal gammapathies and B-cell lymphomas) and damage at other organs due to persistent systemic inflammation, leading to renal, bone, neurological and/or cardiovascular disease. Eradication of HCV with DAAs is associated with amelioration and/or resolution of most liver-related and extrahepatic complications. Ultimately, gains in quality of life and survival favour treating everyone with hepatitis C regardless of liver fibrosis stage.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Cause of Death
  • Hepacivirus*
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / epidemiology
  • Hepatitis C / virology*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / virology
  • Humans
  • Immune System Diseases / diagnosis
  • Immune System Diseases / etiology
  • Liver / drug effects
  • Liver / pathology
  • Liver / virology
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / etiology
  • Mental Disorders / diagnosis
  • Mental Disorders / etiology
  • Mortality
  • Treatment Outcome

Substances

  • Antiviral Agents