Metabolic and cardiovascular complications after virological cure in hepatitis C: What awaits beyond
Open Access
- 7 May 2021
- journal article
- review article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 27 (17), 1959-1972
- https://doi.org/10.3748/wjg.v27.i17.1959
Abstract
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.Keywords
This publication has 92 references indexed in Scilit:
- Risk of myocardial infarction associated with chronic hepatitis C virus infection: a population‐based cohort study*Journal of Viral Hepatitis, 2011
- Metabolic alterations and chronic hepatitis C: treatment strategiesExpert Opinion on Pharmacotherapy, 2011
- Reversal of Hypolipidemia in Chronic Hepatitis C Patients After Successful Antiviral TherapyJournal of the Formosan Medical Association, 2011
- Associations between serum lipids and hepatitis C antiviral treatment efficacyJournal of Hepatology, 2010
- Hepatitis C virus infection and its clearance alter circulating lipids: Implications for long-term follow-upJournal of Hepatology, 2009
- Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis CJournal of Hepatology, 2008
- Involvement of the PA28γ-Dependent Pathway in Insulin Resistance Induced by Hepatitis C Virus Core ProteinJournal of Virology, 2007
- The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwideJournal of Hepatology, 2006
- No Association between Hepatitis C Virus Seropositivity and Acute Myocardial InfarctionClinical Infectious Diseases, 2006
- Production of infectious hepatitis C virus in tissue culture from a cloned viral genomeNature Medicine, 2005