Abstract:
Hepatitis C virus (HCV) infection has been associated as up 40-70% of patients with extrahepatic manifestations (EHM) and 36 different syndromes. These could be attributed to the fact that HCV is lymphotropic, particularly B lymphotropic, and not merely hepatotropic, and could trigger immunological alterations indirectly by exerting a chronic stimulus on the immune system with production of immunoglobulins having rheumatoid activity forming immune complexes and production of cryoglobulins. Cryoglobulinemoa plays a pivotal role in producing most EHM of HCV such as vasculitis, glomerulonephritis, arthritis and neuropathies. Less frequently; while less frequently, the direct viral cytopathic effect could lead to EHMs independent of cryoglobulinemia. The mainstay of treatment of EMH has been antivirals, since interferon era to direct-acting drugs era, with no differences between the two eras, despite the better virological response. Longer evaluation of virological response and clinical investigation with longer follow-ups are necessary.
摘要:
丙型肝炎病毒(HCV)感染与40-70%的肝外表现(EHM)和36种不同综合征的患者相关。这些可以归因于HCV是嗜淋巴细胞的事实,特别是B淋巴,不仅仅是肝性的,并且可以通过对免疫系统施加慢性刺激,产生具有类风湿活性的免疫球蛋白,形成免疫复合物并产生冷球蛋白,从而间接触发免疫学改变。冷球蛋白在产生大多数HCVEHM(如血管炎)中起着关键作用,肾小球肾炎,关节炎和神经病。不太频繁;虽然不太频繁,直接的病毒致细胞病变效应可导致EHMs独立于冷球蛋白血症.EMH的治疗主要是抗病毒药物,从干扰素时代到直接作用药物时代,两个时代之间没有区别,尽管病毒学反应更好。有必要对病毒学应答和临床研究进行更长时间的随访。