Cuesta-Sancho Sara, Márquez-Coello Mercedes, Illanes-Álvarez Francisco, Márquez-Ruiz Denisse, Arizcorreta Ana, Galán-Sánchez Fátima, Montiel Natalia, Rodriguez-Iglesias Manuel, Girón-González José-Antonio
Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain.
Microbiología, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain.
World J Hepatol. 2022 Jan 27;14(1):62-79. doi: 10.4254/wjh.v14.i1.62.
Loss of follow-up or reinfections hinder the expectations of hepatitis C eradication despite the existence of highly effective treatments. Moreover, the elimination of the infection does not imply the reversion of those chronic alterations derived from the previous infection by hepatitis C virus (HCV). This review analyzes the risk factors associated with loss to follow-up in diagnosis or treatment, and the possibility of reinfection. Likewise, it assesses the residual alterations induced by chronic HCV infection considering the liver alterations (inflammation, fibrosis, risk of decompensation, hepatocellular carcinoma, liver transplantation) and, on the other hand, the comorbidities and extrahepatic manifestations (cryoglobulinemia, non-Hodgkin lymphoma, peripheral insulin resistance, and lipid, bone and cognitive alterations). Peculiarities present in subjects coinfected with human immunodeficiency virus are analyzed in each section.
尽管存在高效的治疗方法，但失访或再次感染阻碍了丙型肝炎根除的预期。此外，感染的消除并不意味着由先前丙型肝炎病毒（HCV）感染引起的那些慢性改变会逆转。本综述分析了诊断或治疗中失访的相关危险因素以及再次感染的可能性。同样，它评估了慢性HCV感染引起的残留改变，考虑肝脏改变（炎症、纤维化、失代偿风险、肝细胞癌、肝移植），另一方面，评估合并症和肝外表现（冷球蛋白血症、非霍奇金淋巴瘤、外周胰岛素抵抗以及脂质、骨骼和认知改变）。在每个部分都分析了合并人类免疫缺陷病毒感染的受试者中存在的特殊情况。
