Elsevier

Clinics in Liver Disease

Volume 12, Issue 3, August 2008, Pages 611-636
Clinics in Liver Disease

Extrahepatic Manifestations of Hepatitis C Virus Infection

https://doi.org/10.1016/j.cld.2008.03.012Get rights and content

Hepatitis C virus may cause hepatic and extrahepatic diseases. Extrahepatic manifestations range from disorders for which a significant association with viral infection is supported by epidemiologic and pathogenetic data, to anecdotal observations without clear proof of causality. This article describes the diagnosis and treatment of these diseases.

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Classification of extrahepatic manifestations of hepatitis C virus

Extrahepatic manifestations of HCV infection (EHMs-HCV) range from disorders for which a significant association with HCV infection is supported clearly by multiple lines of evidence to anecdotal observations without clear proof of causality [1], [2]. A tentative classification of EHMs-HCV is suggested in Box 1. According to such classification, extrahepatic manifestations of HCV infection are distinguished, taking into account the robustness of available scientific data. It is thus likely that

Mixed cryoglobulinemia

Mixed cryoglobulinemia (MC) is a systemic vasculitis caused by deposition of circulating immune complexes in the small vessels and characterized by multiple organ involvement, mainly skin, peripheral nerves, kidney, and salivary glands, and less frequently associated with widespread vasculitis and malignant lymphoma [3], [4], [5], [6]. The strong association between HCV and MC has been confirmed repeatedly by serologic and molecular investigations [4], [6], [7]. Generally speaking,

Other extrahepatic disorders and overlap syndromes

Many and different disorders have been linked to HCV infection. In most cases, because of possible methodological bias, mainly in patient selection in the various studies, it is difficult to verify whether the suggested association is coincidental or whether a real pathogenetic link exists. Several conditions are observed more frequently in the context of an MC and quite rarely as idiopathic forms. This is the case of skin, kidney, salivary glands, or lung disorders. In addition, a

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