HCV Extrahepatic Manifestations

Kuna, Lucija; Jakab, Jelena; Stoehr, Robert; Wu, George Y.; Smolić, Martina

doi:10.14218/jcth.2018.00049

Cited by 63 publications

(76 citation statements)

References 126 publications

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“…This was true for conditions known to have causal relationships with HCV, including diabetes, some cancers, and chronic renal failure [5][6][7][8][9][10][15][16][17][18][19], although our estimates for these conditions were generally lower than those in other studies with less stringent, unvalidated methods of chronic disease ascertainment [26,27,29,30] or from clinical charts [25]. For example, we found the prevalence of diabetes in our cohort was 13.27%, compared to 13.8-26.1% in other studies [25-27, 29, 30].…”

Section: Discussionmentioning

confidence: 98%

“…In contrast, the burden of associated extra-hepatic comorbidity is less well known. Several studies have established the association of HCV with chronic kidney disease and renal impairment [5][6][7][8][9][10], depression [11][12][13], neurological disorders [14] and malignancies [15,16], whereas the evidence is less consistent for association with diabetes mellitus [7,[17][18][19] and cardiovascular disease [17,[20][21][22]. With other comorbidities, the association is related to common risk factors including smoking, excess alcohol use, recreational drug use, and poverty [23,24].…”

Section: Introductionmentioning

confidence: 99%

“…Liu et al [28] reported on multiple comorbidities in their study of Taiwanese adult HCV patients using a physician-completed survey, as did Ruzicka et al [29] in their study of Japanese adult HCV patients using a medical claims database and Louie et al [30] in their study of patients with chronic HCV using a US medical claims database. All of these studies showed a significant prevalence of multiple comorbidities (e.g., more than 50% of Japanese HCV patients had ≥4 comorbidities, and 52% of US patients reported [6][7][8][9][10][11][12][13][14][15], with the latter two showing this to be greater than amongst matched controls (e.g., only 29.5% of Japanese non-HCV patients had ≥4, and over 47% of US patients reported ≤5 comorbidities). However, these studies either did not use validated or standardized ascertainment methods, or the diagnoses focused on were illdefined.…”

Section: Introductionmentioning

confidence: 99%

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HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study

et al. 2019

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Background: Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment uptake and cure in the pre-and post-direct acting antiviral (DAA) era. Methods: We linked adults with HCV at The Ottawa Hospital Viral Hepatitis Program as of April 1, 2017 to provincial health administrative data and matched on age and sex to 5 Ottawa-area residents for comparison. We used validated algorithms to identify the prevalence of mental and physical health comorbidities, as well as multimorbidity (2+ comorbidities). We calculated direct age-and sex-standardized rates of comorbidity and comparisons were made by interferon-based and interferon-free, DAA HCV treatments. Results: The mean age of the study population was 54.5 years (SD 11.4), 65% were male. Among those with HCV, 4% were HIV co-infected, 26% had liver cirrhosis, 47% received DAA treatment, and 57% were cured of HCV. After accounting for age and sex differences, the HCV group had greater multimorbidity (prevalence ratio (PR) 1.38, 95% confidence interval (CI) 1.20 to 1.58) and physical-mental health multimorbidity (PR 2.71, 95% CI 2.29-3.20) compared to the general population. Specifically, prevalence ratios for people with HCV were significantly higher for diabetes, renal failure, cancer, asthma, chronic obstructive pulmonary disease, substance use disorder, mood and anxiety disorders and liver failure. HCV treatment and cure were not associated with multimorbidity, but treatment prevalence was significantly lower among middle-aged individuals with substance use disorders despite no differences in prevalence of cure among those treated. Conclusion: People with HCV have a higher prevalence of comorbidity and multimorbidity compared to the general population. While HCV treatment was not associated with multimorbidity, people with substance use disorder were less likely to be treated. Our results point to the need for integrated, comprehensive models of care delivery for people with HCV.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study

et al. 2019

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“…Chronic HCV infection and HCV-induced metabolic diseases influence each other closely, as the coexisting metabolic disorders with HCV infection increases the risk of HCC, developing into advanced fibrosis [47].…”

Section: Interaction Between Antiviral Treatment and Irmentioning

confidence: 99%

Management of Diabetes Mellitus in Patients with Chronic Liver Diseases

Zhao

Xing

Wang

et al. 2019

Journal of Diabetes Research

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Diabetes mellitus (DM) is a common chronic disease affecting humans globally. During the last few years, the incidence of diabetes has increased and has received more attention. In addition to growing DM populations, DM complications are involving injuries to more organs, such as the heart and cerebral vessel damage. DM complications can reduce quality of life and shorten life spans and eventually also impede social and economic development. Therefore, effective measures to curb the occurrence and development of diabetes assist in improving patients’ quality of life, delay the progression of DM in the population, and ease a social burden. The liver is regarded as an important link in the management and control of DM, including the alleviation of glucose metabolism and lipid metabolism and others via glucose storage and endogenous glucose generation from glycogen stored in the liver. Liver cirrhosis is a very common chronic disease, which often lowers the quality of life and decreases life expectancy. According to a growing body of research, diabetes shows a close correlation with hepatitis, liver cirrhosis, and liver cancer. Moreover, coexistence of liver complications would accelerate the deterioration of patients with diabetes. Liver cirrhosis and diabetes influence each other. Thus, in addition to pharmacological treatments and lifestyle interventions, effective control of cirrhosis might assist in a better management of diabetes. When it comes to different etiologies of liver cirrhosis, different therapeutic methods, such as antiviral treatment, may be more effective. Effective control of cirrhosis might be a strategy for better management of diabetes.

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“…HCV infection may also contribute to or even directly cause renal diseases for example by triggering membranoproliferative glomerulonephritis linked to type II mixed cryoglobulinemia or by an acceleration of artherogenesis. In addition, diabetes mellitus is a common extrahepatic manifestation of chronic HCV infection . Moreover, patients with chronic kidney disease and additional HCV infection are at higher risk for progression to end‐stage renal disease and for patients on haemodialysis a meta‐analysis indicates an increased risk of mortality .…”

mentioning

confidence: 99%