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Impact of Direct Acting Antiviral Agent Therapy upon Extrahepatic Manifestations of Hepatitis C Virus Infection

  • Co-infections and Comorbidity (S Naggie, Section Editor)
  • Published:
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Abstract

Purpose of Review

Direct acting antiviral agents (DAAs) have emerged as simple, short, safe, and effective treatments for chronic hepatitis C (CHC) infection. CHC is a systemic disease with frequent and multiple extrahepatic manifestations. The beneficial effects of DAA treatment regimens extend beyond improvement in liver-related outcomes to amelioration of extra hepatic manifestations and are likely to have economic implications. The purpose of this review is to evaluate the effect of DAAs on extra hepatic manifestations of CHC virus infection.

Recent Findings

Recent studies indicate that DAAs are associated with reduction in all-cause mortality, even in patients without significant hepatic fibrosis. They are also associated with reduction in incident cardiovascular disease and diabetes. DAAs are the mainstay of treatment in HCV-associated cryoglobulinemia and lymphoma. Successful HCV therapy with DAAs also improves patient-related outcomes such as health-related quality of life.

Summary

DAAs improve extrahepatic manifestations of CHC virus infection. Future studies are needed to evaluate the long-term durability of treatment response and for accounting amelioration of extrahepatic manifestations into the cost effectiveness of DAA regimens.

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Abbreviations

DAA:

Directly acting antiviral agents

CHC:

Chronic hepatitis C

HCV:

Hepatitis C virus

PROs:

Patient-related outcomes

HRQOL:

Health-related quality of life

VA:

Veterans Affairs

SVR:

Sustained virologic response

MC:

Mixed cryoglobulinemia

NHL:

Non-Hodgkin’s lymphoma

DLBCL:

Diffuse large B cell lymphoma

HbA1C :

Hemoglobin A1C

CVD:

Cardiovascular disease

CKD:

Chronic kidney disease

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Authors and Affiliations

  1. Boston University School of Medicine, Boston, MA, USA

    Arpan Mohanty

  2. Hamad Medical Corporation, Doha, Qatar

    Sarah Salameh & Adeel A. Butt

  3. VA Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Adeel A. Butt

  4. Weill Cornell Medical College, New York, NY, USA

    Adeel A. Butt

  5. Weill Cornell Medical College, Doha, Qatar

    Adeel A. Butt

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Mohanty, A., Salameh, S. & Butt, A.A. Impact of Direct Acting Antiviral Agent Therapy upon Extrahepatic Manifestations of Hepatitis C Virus Infection. Curr HIV/AIDS Rep 16, 389–394 (2019). https://doi.org/10.1007/s11904-019-00466-1

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