Hepatitis C virus-associated pruritus: Etiopathogenesis and therapeutic strategies

Abstract

In addition to its contributing role in the development of chronic liver diseases, chronic hepatitis C virus (HCV) infection is associated with extrahepatic manifestations, particularly, cutaneous-based disorders including those with pruritus as a symptom. Pruritus is frequently associated with the development of chronic liver diseases such as cholestasis and chronic viral infection, and the accumulation of bile acids in patients’ sera and tissues as a consequence of liver damage is considered the main cause of pruritus. In addition to their role in dietary lipid absorption, bile acids can trigger the activation of specific receptors, such as the G protein-coupled bile acid receptor (GPBA/ TGR5). These types of receptors are known to play a crucial role in the modulation of the systemic actions of bile acids. TGR5 expression in primary sensory neurons triggers the activation of the transient receptor potential vanilloid 1 (TRPV1) leading to the induction of pruritus by an unknown mechanism. Although the pathologic phenomenon of pruritus is common, there is no uniformly effective therapy available. Understanding the mechanisms regulating the occurrence of pruritus together with the conduction of large-scale clinical and evidence-based studies, may help to create a standard treatment protocol. This review focuses on the etiopathogenesis and treatment strategies of pruritus associated with chronic HCV infection.

Ethnic differences and comorbidities of 909 prurigo nodularis patients

“…Indeed, many of the underlying conditions thought to contribute to the development of PNdsuch as AD, type 2 diabetes mellitus, chronic kidney disease, and chronic liver diseasedhave a higher incidence in African Americans. 2,6–8 Our study also found that compared with all the control groups, both African American and white patients with PN had a statistically significantly increased risk of having the 4 aforementioned conditions (Supplemental Tables II and III).…”

Uremic Pruritus is Associated with Two-Year Cardiovascular Mortality in Long Term Hemodialysis Patients

“…Pruritus due to HCV infection has been noted in several studies including HD patients with HCV infection [34][35][36]. The possible etiologies are HCV-induced cholestasis, increased production of cytokines and chemokines.…”

Infectious differential diagnosis of chronic generalized pruritus without primary cutaneous lesions: a review of the literature

“…Infection with hepatitis C virus (HCV) typically results in chronic liver diseases and hepatitis; however, it is also associated with many extrahepatic manifestations such as renal diseases, autoimmune disorders, hematological diseases, and dermatological conditions . Pruritus is frequently observed in subjects with chronic hepatic disorders such as cholestasis or chronic viral infections . It is believed that liver damage results in the accumulation of bile acids in the tissues, which triggers the mechanism of itching, but the pathogenesis is still uncertain.…”

“…Pruritus is frequently observed in subjects with chronic hepatic disorders such as cholestasis or chronic viral infections . It is believed that liver damage results in the accumulation of bile acids in the tissues, which triggers the mechanism of itching, but the pathogenesis is still uncertain.…”