Direct-Acting Antivirals for HCV-Associated Rheumatic Diseases

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Not only is the hepatitis C virus (HCV) the cause of liver diseases in up to 170 million people worldwide, it also has many extrahepatic disease manifestations. These include rheumatic, hematologic, cardiovascular diseases.

In a review article published in Rheumatic Disease Clinics of North America, Patrice Cacoub, MD, from the Pitié-Salpêtrière University Hospital, Paris, France, and colleagues discuss the main rheumatologic diseases associated with chronic HCV infection, and how direct-acting antiviral agents (DAAs) have affected these extrahepatic manifestations.

According to the authors, HCV infection is frequently associated with clinical and biological rheumatologic manifestations, including arthralgia, myalgia, cryoglobulinemia vasculitis, sicca syndrome, and autoantibody production.

The authors note that recent data also show that HCV infection leads to increased cardiometabolic-related morbidity and mortality. “Patients with HCV chronic infection have an increased prevalence of carotid atherosclerosis and increased intima-media thickness,” they say. Active chronic HCV infection also seems to be an independent risk factor for ischemic cerebrovascular accidents and ischemic heart disease. It has also been associated with higher rates of diabetes mellitus and insulin resistance when compared to healthy individuals.

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