Systematic review with meta‐analysis: extrahepatic manifestations in chronic hepatitis C virus‐infected patients in East Asia

Abstract

Background: Although the prevalence of extrahepatic manifestations of chronic hepatitis C virus (HCV) infection has been reported from Western countries, their prevalence in East Asian countries is not well known. Aim:To perform a systematic review to quantify the prevalence of selected extrahepatic manifestations of HCV among patients from East Asia.Methods: Medline, CINAHL, EMBASE, Cochrane and country-specific databases were reviewed according to standard guidelines for meta-analyses. Only articles with patients from East Asian countries were included. Results:After review, 34 articles were selected (Japan = 9; China = 5, Korea = 3, Taiwan = 16, multiple countries = 1) with 646 228 subjects, 66 436 with HCV.Mean age for HCV-infected patients was 56 years (range 41-72 years), 50% were male (range 26%-73%). The pooled prevalence of type 2 diabetes in East Asian HCV patients was 19.0% (95% confidence interval 15.6%-22.9%) (n = 19 studies) with an increased risk when compared to non-HCV: odds ratio (OR) 1.58 (1.28-1.94). The prevalence of chronic kidney disease in HCV was 9.2% (5.0%-16.2%) (n = 7 studies), also with a significantly increased risk: OR=1.98 (1.41-2.77). Pooled prevalence of cardiovascular disease in HCV was 8.6% (3.5%-19.9%) (n = 6 studies), also with an increased risk: OR = 1.55 (1.21-1.98). The prevalence of lichen planus in HCV was 8.9% (3.6%-20.6%) (n = 6 studies) while the prevalence of rheumatoid arthritis was 4.5% (0.6%-25.7%) (n = 4 studies). Conclusions:These data show increased risk of developing extrahepatic manifestations in East Asian patients with HCV. Both hepatic and extrahepatic manifestations of the infection should be used to accurately determine the total burden of the disease in the region.

The effects of sustained virological response to direct‐acting anti‐viral therapy on the risk of extrahepatic manifestations of hepatitis C infection

“…HCV infection leads to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Chronic HCV infection is also associated with several extrahepatic manifestations, including essential mixed cryoglobulinaemia, some subtypes of B‐cell non‐Hodgkin lymphoma (NHL), membranoproliferative glomerulonephritis, porphyria cutanea tarda and lichen planus . There is also consistent epidemiological evidence supporting the association of chronic HCV infection with type‐2 diabetes mellitus.…”

The applicability of non-invasive methods for assessing liver fibrosis in hemodialysis patients with chronic hepatitis C

“…The small but substantial annual incidence of viral hepatitis seroconversion in hemodialysis units were reported to be 0.22-6.20% of hepatitis C virus (HCV), varies by different geographic distributions [4,5]. Chronic HCV infection is associated with chronic kidney diseases and end stage renal disease (ESRD) [6,7]. Therefore, HCV is not only hyperendemic in general population of Taiwan (around 3%) [8,9], but also hyperendemic in Taiwanese uremic patients under maintenance hemodialysis (17%-34%) [10][11][12].…”

Interferon-based therapy did not attenuate hepatitis C-associated rheumatic disorder risk: A nationwide population-based cohort study

“…Hepatitis C virus (HCV) is a human pathogen responsible for acute and chronic liver disease that infects an estimated 150 million individuals worldwide [1]. In addition to hepatic complications including cirrhosis and hepatocellular carcinoma, HCV may cause many extrahepatic complications such as diabetes mellitus (DM), hypolipidemia, cardiovascular events [1], and rheumatic disorders [2]. HCV is both hepatotropic and lymphotropic [3].…”

“…HCV infection was also associated with increased RA risks [16][17], and the pooled prevalence of RA was 4.5% (0.6%-25.7%) of chronic HCV-infected patients in East Asia [2]. Moreover, the prevalence of HCV infection among SLE patients was found up be 10% [18].…”