Abstract
HCV is a global health problem affecting mainly the liver and is often characterized by extrahepatic manifestations mediated by autoimmune reactions. Among these, arthritis and arthralgia are most frequent, as well as the presence of cryoglobulinemia that may induce vasculitis and sicca syndrome. Thus, HCV appears to be a trigger for an autoimmune response, as demonstrated by the finding of autoantibody in a high percentage of serum of these patients. Therefore, it is important that clinicians recognize these autoimmune manifestations as symptoms due to an autoimmune activity triggered by HCV in order to give the correct diagnosis and start an effective therapeutic strategy. Therefore, clinical examination, searching of markers of infection, as well as autoantibody patterns should be performed to make a correct differential diagnosis. The treatment should be based on antiviral drugs associated with immunosuppressive drugs according to autoimmune manifestations.
Keywords: HCV, autoimmunity, arthritis, cryoglobulinemia, sjogren’s syndrome, rheumatic diseases.
Graphical Abstract
[http://dx.doi.org/10.1177/0961203314556140]
[PMID: 31293918]
[http://dx.doi.org/10.1016/S0049-0172(98)80043-7] [PMID: 9806371]
[http://dx.doi.org/10.1002/hep.1840190407] [PMID: 8138255]
[http://dx.doi.org/10.1046/j.1365-2249.2003.02030.x] [PMID: 12519394]
[http://dx.doi.org/10.1136/ard.57.12.728] [PMID: 10070272]
[PMID: 9164512]
[http://dx.doi.org/10.1016/S0025-6196(11)65122-7] [PMID: 10319074]
[http://dx.doi.org/10.1016/j.autrev.2011.11.011] [PMID: 22155016]
[http://dx.doi.org/10.1046/j.1365-2249.2002.01827.x]
[http://dx.doi.org/10.1080/0891693031000152660] [PMID: 14567556]
[http://dx.doi.org/10.1093/ndt/13.1.213] [PMID: 9481747]
[PMID: 7533120]
[http://dx.doi.org/10.1590/S1413-86702011000100012] [PMID: 21412592]
[http://dx.doi.org/10.1002/hep.510230201] [PMID: 8591841]
[http://dx.doi.org/10.2165/00063030-200115090-00002] [PMID: 11580301]
[http://dx.doi.org/10.1016/j.autrev.2008.07.025] [PMID: 18707027]
[PMID: 15005003]
[http://dx.doi.org/10.1002/art.20355] [PMID: 15248231]
[http://dx.doi.org/10.1007/s00296-009-1225-8] [PMID: 19882340]
[PMID: 10743797]
[http://dx.doi.org/10.1517/14656566.6.1.27] [PMID: 15709880]
[PMID: 12563365]
[http://dx.doi.org/10.1093/rheumatology/keh668] [PMID: 15855185]
[PMID: 10895374]
[PMID: 10990230]
[http://dx.doi.org/10.1016/S0140-6736(98)07124-4] [PMID: 9807989]
[http://dx.doi.org/10.1016/j.semarthrit.2003.10.001] [PMID: 15190522]
[http://dx.doi.org/10.1016/S0140-6736(11)60242-0] [PMID: 21868085]
[http://dx.doi.org/10.1016/j.jhep.2007.03.021] [PMID: 17512627]
[PMID: 18088248]
[http://dx.doi.org/10.1097/MNH.0b013e3282f8afe2] [PMID: 18408474]
[http://dx.doi.org/10.1073/pnas.0509402102] [PMID: 16339892]
[http://dx.doi.org/10.1046/j.1365-2249.1996.d01-639.x] [PMID: 8603528]
[http://dx.doi.org/10.1111/j.1365-2249.1992.tb03001.x] [PMID: 1311992]
[http://dx.doi.org/10.1016/S0168-8278(98)80270-5] [PMID: 9833927]
[http://dx.doi.org/10.2353/ajpath.2006.050491] [PMID: 16436653]
[http://dx.doi.org/10.1053/j.ajkd.2006.09.015] [PMID: 17185147]
[http://dx.doi.org/10.1016/S0165-5728(96)00191-9] [PMID: 9058770]
[http://dx.doi.org/10.1002/hep.28297] [PMID: 26474537]
[http://dx.doi.org/10.1182/blood-2009-10-248518] [PMID: 20439619]
[http://dx.doi.org/10.1046/j.1365-2796.1999.00414.x] [PMID: 10081515]
[http://dx.doi.org/10.1016/0140-6736(92)91645-O] [PMID: 1346409]
[http://dx.doi.org/10.1016/0168-8278(95)80461-7] [PMID: 7650344]
[http://dx.doi.org/10.1016/S0002-9440(10)63964-8] [PMID: 11141499]
[PMID: 12415596]
[http://dx.doi.org/10.1016/S1386-6346(03)00196-7] [PMID: 12957203]
[PMID: 12516900]
[http://dx.doi.org/10.1097/01.md.0000157397.30055.c9] [PMID: 15758837]