Cacoub Patrice, Gragnani Laura, Comarmond Cloe, Zignego Anna Linda
Sorbonne University, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France; INSERM, UMR_S 959, Paris, France; CNRS, FRE3632, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France.
Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MaSVE), Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Dig Liver Dis. 2014 Dec 15;46 Suppl 5:S165-73. doi: 10.1016/j.dld.2014.10.005. Epub 2014 Nov 8.
Hepatitis C virus (HCV) infected patients are known to be at risk of developing liver complications i.e. cirrhosis and liver cancer. However, the risks of morbidity and mortality are underestimated because they do not take into account non-liver consequences of chronic hepatitis C virus infection. Numerous extrahepatic manifestations have been reported in up to 74% of patients, from perceived to disabling conditions. The majority of data concern hepatitis C virus-related autoimmune and/or lymphoproliferative disorders, from mixed cryoglobulinaemia vasculitis to frank lymphomas. More recently, other hepatitis C virus-associated disorders have been reported including cardiovascular, renal, metabolic, and central nervous system diseases. This review aims to outline most of the extrahepatic manifestations that are currently being investigated, including some of autoimmune and/or lymphoproliferative nature, and others in which the role of immune mechanisms appears less clear. Beyond the liver, hepatitis C virus chronic infection should be analyzed as a multifaceted systemic disease leading to heavy direct and indirect costs. The accurate consideration of extrahepatic consequences of such a systemic infection significantly increases the weight of its pathological burden. The need for effective viral eradication measures is underlined.
已知丙型肝炎病毒（HCV）感染患者有发生肝脏并发症（即肝硬化和肝癌）的风险。然而，发病率和死亡率的风险被低估了，因为这些风险没有考虑到慢性丙型肝炎病毒感染的非肝脏后果。高达74%的患者报告了许多肝外表现，从可感知的情况到致残性疾病。大多数数据涉及丙型肝炎病毒相关的自身免疫性和/或淋巴增殖性疾病，从混合性冷球蛋白血症性血管炎到明显的淋巴瘤。最近，还报告了其他丙型肝炎病毒相关疾病，包括心血管、肾脏、代谢和中枢神经系统疾病。本综述旨在概述目前正在研究的大多数肝外表现，包括一些自身免疫性和/或淋巴增殖性疾病，以及其他免疫机制作用似乎不太明确的疾病。除肝脏外，丙型肝炎病毒慢性感染应被视为一种多方面的全身性疾病，会导致巨大的直接和间接成本。准确考虑这种全身性感染的肝外后果会显著增加其病理负担的权重。强调了采取有效病毒根除措施的必要性。
