Review Article

Extrahepatic Manifestations of Hepatitis C

Authors: Nicole A. Palekar, MD, Stephen A. Harrison, MD

Abstract

Hepatitis C affects approximately 170 million people worldwide. Extrahepatic manifestations of chronic hepatitis C infection are clinically evident in nearly 40% of patients. Much research has been done over the last decade to better understand their incidence, clinical presentation, mechanism of disease, and the role of antiviral therapy in their treatment. Of the commonly reported manifestations, cryoglobulinemia, membranoproliferative glomerulonephritis, and porphyria cutanea tarda remain the best understood manifestations. More recently, the association of insulin resistance and diabetes mellitus with chronic hepatitis C has been demonstrated. This paper serves to review the growing body of literature detailing the extrahepatic manifestations of chronic hepatitis C.


Key Points


* Extrahepatic manifestations are commonly seen in patients with hepatitis C.


* Mixed cryoglobulinemia, membranoproliferative glomerulonephritis and porphyria cutanea tarda appear to have the strongest association.


* Antiviral therapy with interferon 2a, interferon 2b, and ribaviron is effective in the treatment of some extrahepatic diseases but relapse rates are high if the virus is not eradicated.

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