Extrahepatic Manifestations of Hepatitis C: A Meta-analysis of Prevalence, Quality of Life, and Economic Burden

Younossi, Zobair M.; Park, Haesuk; Henry, Linda; Adeyemi, Ayoade; Stepanova, Maria

doi:10.1053/j.gastro.2016.02.039

Cited by 332 publications

(325 citation statements)

References 25 publications

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“…Another recent study from France estimated the same burden of EHMs of HCV to be V256 million per year (2015). 82 It is important to note that the prevalence of EHMs in this study were high in comparison with other similar reports (eg, the prevalence of mixed cryoglobulinemia in HCV was 51% with the rate of hospitalization for it of 26%, which well exceeds other similar estimates 81,83,84 ) and, thus, the reported national cost of the EHMs substantially exceeded the cost of all HCV-related inpatient hospital stays in the country, including those for liver transplantation. 85 A number of reports on the prevalence rates of EHMs of HCV in other countries suggested notably high rates of up to 75%, 86-89 but so far have not been accompanied by the cost of illness analyses.…”

Section: Economic Burden Of the Extrahepatic Manifestations Of Hepaticontrasting

confidence: 47%

“…The study suggested that the total direct annual burden of EHMs for the United States could be as high as $1.5 billion (2014 US dollars). 81 In PPPY expenses, the most expensive EHM was suggested to be end-stage renal disease, and the overall contribution to the national EHM burden was estimated to be the greatest for HCV-induced type 2 diabetes and depression (both accounting for approximately 30% of all direct medical expenses). In addition, excessive prevalence of cardiovascular diseases and mixed cryoglobulinemia in patients with HCV were estimated to cost more than $100 million per year each.…”

Section: Economic Burden Of the Extrahepatic Manifestations Of Hepatimentioning

confidence: 99%

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Economic Burden of Hepatitis C Infection

Stepanova

Younossi

2017

Clinics in Liver Disease

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Section: Economic Burden Of the Extrahepatic Manifestations Of Hepaticontrasting

confidence: 47%

Section: Economic Burden Of the Extrahepatic Manifestations Of Hepatimentioning

confidence: 99%

Economic Burden of Hepatitis C Infection

Stepanova

Younossi

2017

Clinics in Liver Disease

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“…Currently, it is known that HCV infection is associated with insulin-resistance, T2DM, and liver steatosis (21). In a recent meta-analysis, DM is considered as the second most common extra-hepatic manifestation of HCV (after depression), found in 15% of the patients (22). The high proportion of patients with raised glycemic values could be explained by the advanced stage of liver fibrosis in the cohort studies, knowing that in HCV infection, T2DM correlates with the degree of hepatic fibrosis (23).…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome and Genotype 1 Virus C Compensated Liver Cirrhosis in the Era of Directly Acting Antiviral Therapy

et al. 2017

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Objectives: The current study aimed at evaluating the association between metabolic syndrome (MeS) in patients with hepatitis C virus (HCV) liver cirrhosis (compensated, genotype, 1b) and changes after sustained viral response (SVR) following a 12-week therapy with paritaprevir, ritonavir, ombitasvir, dasabuvir, and ribavirin (PrOD+R). Methods: The current multicenter retrospective study included 809 patients diagnosed with compensated HCV cirrhosis (child class A), all 1b genotype treated for 12 weeks with direct acting antiviral agents -PrOD+R -regimen (according to the protocol practiced in Romania) and achieved SVR. The parameters of MeS (according to the definition of the International Diabetes Federation) were collected from medical records before and 12 weeks after the treatment. The results were collected in a central database and analyzed with SPSS 18.0. Statistical analysis used both descriptive and analytical methods with a significance level of 95% (CI 95%). Results: Out of the 809 patients, 105 (13%) demonstrated 3 out of the 5 criteria for MeS. Based on the MeS criteria, the commonest parameters were abnormal glycaemia (54.1%), followed by visceral obesity (38.6%), raised triglycerides (26.1%), high blood pressure (12.1%), and a low high-density lipoprotein (HDL)-cholesterol (4.6%). The re-assessment of MeS parameters after SVR showed favourable changes, which were statistically significant: a siginficanttly lower serum triglyeride level (182.32 vs. 153.50 mg/dL, P = 0.001), lower systolic arterial blood pressure (130.57 vs. 124.85 mmHg; P = 0.001), lower diastolic arterial blood pressure (80.26 vs. 78.42 mmHg; P = 0.001) and lower glyceamic levels (130.06 vs. 120.71 mg/dL; P = 0.001), as well as a significant rise in HDL-cholesterol levels (48.61 vs. 50.50 mg/dL; P = 0.003). Abdominal circumference was the only parameter, which did not change after SVR. Following the changes sustained after SVR, 26.7% of the patients no longer fulfilled the minimum 3 criteria for MeS. No correlation was observed between the presence of MeS and the risk of severe adverse events, but it was noted that 37.5% of the patients who decompensated, 66.7% of the ones who developed hepatocarcinoma and 100% of the ones that died of abnormal glycaemic levels. Conclusions: Hyperglycemia, and not MeS, is associated with HCV compensated liver cirrhosis genotype 1b, and is a risk factor for severe adverse events. The attainment of SVR through PrOD+R regimen results in short-term improvements in MeS parameters.

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“…Az extrahepaticus manifesztációk a HCV-fertőzöttek megbetegedését, halálozását jelentősen befolyásolják, életminőségüket rontják [10]. Az extrahepaticus szervek érintettségének kezelése részben a vírusellenes kezelést, a B-sejt-depléciót jelenti az immunkomplexek, krioglobulinok képződésének megakadályozására, valamint a nem specifikus immunszuppresszív kezelést foglalja magában, amelynek célja a gyulladásos sejtek immunkomplexképzésének gátlása, valamint a cryoglobulinaemiás vasculitis kezelése [11,12].…”

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Extrahepaticus manifesztációk idült hepatitis C-vírus-fertőzöttekben

2017

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A hepatitis C-vírus-fertőzés egészségügyi jelentősége világszerte kiemelkedő, a világ lakosságának 3%-a fertőzött. Idült hepatitis C-fertőzöttek körülbelül 50%-ában alakul ki extrahepaticus betegség, amely a betegek kilátásait, mortalitását rontja. Kialakulásuk hátterében részben krioglobulinok képződése, immunmechanizmusok, valamint a vírus direkt hatásai állhatnak. A szerzők összefoglalják a hepatitis C-vírus-fertőzéssel összefüggő szervi érintettségeket, valamint a kezelés lehetőségeit. Közleményükkel a társszakmák figyelmét kívánják felhívni a fertőzés sokszínűségére, ezzel segítve a kórkép felismerését a hatékony direkt antivirális készítmények időszakában. Orv. Hetil., 2017, 158(16), 603-612.Kulcsszavak: hepatitis C-vírus-fertőzés, extrahepaticus manifesztáció, cryoglobulinaemia, vasculitis, antivirális kezelés Extrahepatic manifestations in chronic hepatitis C infected patientsThe importance of chronic hepatitis C infection is significant. 3% of the World's population is infected. There is at least one extrahepatic manifestation in 50% of HCV patients, which makes the prognosis and mortality worse. The pathomechanisms included are cryoglobulin production, immunmechanisms, and direct viral effects. The authors summarize the main extrahepatic manifestations, as well as treatment possibilities. The aim is to draw attention to this colourful infection in order to improve the recognition in the era of the new effective direct antiviral agents. ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítés CCP = ciklikus citrunilált peptid; HCAO = (hepatitis C associated osteosclerosis) hepatitis C-vel összefüggő osteosclerosis; HCV = hepatitis C-vírus; IL = interleukin; ITP = immunthrombocytopeniás purpura; LAC-diéta = (low-antigen-content diet) alacsony antigéntartalmú diéta; MALT-lymphoma = (mucosa-associated lymphoid tissue) mucosaasszociált lymphoid szöveti lymphoma; MGN = membranosus glomerulonephritis; MGUS = (monoclonal gammopathy of undetermined significance) nem meghatározott jelentőségű monoklonális gammopathia; MHC = major hisztokompatibilitási komplex; MPGN = membranoproliferativ glomerulonephritis; NHL = non-Hodgkin-lymphoma; WHO = World Health Organization A hepatitis C-vírus-(HCV-) fertőzés egészségügyi jelentősége világszerte kiemelkedő, a megbetegedési és a halálozási statisztikákban meghatározó [1]. A fertőzöttek számát 210 millióra becsülik, a WHO adatai alapján a világ lakosságának körülbelül 3%-a fertőzött. Évente 3-4 millió az új fertőzés, valamint 366 000 a HCV okozta halálozás [2].A HCV-fertőzés lehetséges következménye az idült májkárosodás, a cirrhosis és a hepatocellularis carcinoma kialakulása. A HCV a cirrhosisok 27%-áért, a hepatocellularis carcinomák 25-31%-áért felelős [2,3].Heveny fertőzések 60%-ában alakul ki idült hepatitis, de a vírus direkt hatása, inváziója, replikációja révén, va-

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Extrahepatic Manifestations of Hepatitis C: A Meta-analysis of Prevalence, Quality of Life, and Economic Burden

Cited by 332 publications

References 25 publications

Economic Burden of Hepatitis C Infection

Economic Burden of Hepatitis C Infection

Metabolic Syndrome and Genotype 1 Virus C Compensated Liver Cirrhosis in the Era of Directly Acting Antiviral Therapy

Extrahepaticus manifesztációk idült hepatitis C-vírus-fertőzöttekben

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