Palazzi C, D’Amico E, D’Angelo S, Gilio M, Olivieri I. Rheumatic manifestations of hepatitis C virus chronic infection: Indications for a correct diagnosis. World J Gastroenterol 2016; 22(4): 1405-1410 [PMID: 26819509 DOI: 10.3748/wjg.v22.i4.1405]
Corresponding Author of This Article
Carlo Palazzi, MD, Senior Investigator, Rheumatology Department of Basilicata, San Carlo Hospital, Potenza and Madonna delle Grazie Hospital, C.da Cattedra Ambulante, 75100 Matera, Italy. kaps57@virgilio.it
Research Domain of This Article
Rheumatology
Article-Type of This Article
Topic Highlight
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 28, 2016; 22(4): 1405-1410 Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1405
Rheumatic manifestations of hepatitis C virus chronic infection: Indications for a correct diagnosis
Carlo Palazzi, Emilio D’Amico, Salvatore D’Angelo, Michele Gilio, Ignazio Olivieri
Carlo Palazzi, Salvatore D’Angelo, Michele Gilio, Ignazio Olivieri, Rheumatology Department of Basilicata, San Carlo Hospital, Potenza and Madonna delle Grazie Hospital, 75100 Matera, Italy
Emilio D’Amico, Division of Internal Medicine, San Massimo Hospital, 86027 Penne, Italy
Author contributions: All authors have contributed to conceive and design this review, to analyze the literature and revise the paper; and Palazzi C drafted the manuscript.
Conflict-of-interest statement: Authors have no financial interests which could create a potential conflict of interest or the appearance of a conflict of interest with regard to the work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlo Palazzi, MD, Senior Investigator, Rheumatology Department of Basilicata, San Carlo Hospital, Potenza and Madonna delle Grazie Hospital, C.da Cattedra Ambulante, 75100 Matera, Italy. kaps57@virgilio.it
Telephone: +39-835-253807 Fax: +39-971-983036
Received: May 29, 2015 Peer-review started: June 4, 2015 First decision: September 11, 2015 Revised: November 17, 2015 Accepted: December 12, 2015 Article in press: December 14, 2015 Published online: January 28, 2016 Processing time: 236 Days and 0.9 Hours
Abstract
Hepatitis C virus (HCV) is a hepato- and lymphotropic agent that is able to induce several autoimmune rheumatic disorders: vasculitis, sicca syndrome, arthralgias/arthritis and fibromyalgia. The severity of clinical manifestations is variable and sometimes life-threatening. HCV infection can mimic many primitive rheumatic diseases, therefore, it is mandatory to distinguish HCV-related manifestations from primitive ones because the prognosis and therapeutic strategies can be fairly dissimilar. The new direct-acting antivirals drugs can help to avoid the well-known risks of worsening or new onset of autoimmune diseases during the traditional interferon-based therapies.
Core tip: As a consequence of its lymphotropic nature, hepatitis C virus (HCV) can trigger and sustain a clonal B-cell expansion which causes a wide spectrum of autoimmune/lymphoproliferative disorders, through a multistep process. These extrahepatic manifestations become clinically manifest in 40%-70% of the patients and they can be frequently classified among the rheumatic ones. Furthermore, HCV can promote the production of several autoantibodies complicating the differential diagnosis between primitive and HCV-related rheumatic disorders.
