Cuesta-Sancho S, Márquez-Coello M, Illanes-Álvarez F, Márquez-Ruiz D, Arizcorreta A, Galán-Sánchez F, Montiel N, Rodriguez-Iglesias M, Girón-González JA. Hepatitis C: Problems to extinction and residual hepatic and extrahepatic lesions after sustained virological response. World J Hepatol 2022; 14(1): 62-79 [PMID: 35126840 DOI: 10.4254/wjh.v14.i1.62]
Corresponding Author of This Article
José-Antonio Girón-González, MD, PhD, Doctor, Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Avda Ana de Viya, s/n, Cádiz 11009, Spain. joseantonio.giron@uca.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
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 Hepatol. Jan 27, 2022; 14(1): 62-79 Published online Jan 27, 2022. doi: 10.4254/wjh.v14.i1.62
Hepatitis C: Problems to extinction and residual hepatic and extrahepatic lesions after sustained virological response
Sara Cuesta-Sancho, Mercedes Márquez-Coello, Francisco Illanes-Álvarez, Denisse Márquez-Ruiz, Ana Arizcorreta, Fátima Galán-Sánchez, Natalia Montiel, Manuel Rodriguez-Iglesias, José-Antonio Girón-González
Sara Cuesta-Sancho, Mercedes Márquez-Coello, Francisco Illanes-Álvarez, Denisse Márquez-Ruiz, Ana Arizcorreta, José-Antonio Girón-González, Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
Fátima Galán-Sánchez, Natalia Montiel, Manuel Rodriguez-Iglesias, Microbiología, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Cádiz 11009, Spain
Author contributions: Cuesta-Sancho S and Márquez-Coello M are equal contributions; Cuesta-Sancho S, Márquez-Coello M, Girón-González JA wrote the draft; All authors conceived and designed, analyzed the data; all authors contributed to critical revision of the manuscript, and saw and approved the final version.
Supported byConsejería de Salud, Junta de Andalucía, Integrated Territorial Initiative for the province of Cádiz, No. (ITI) 2014-2020; Cofinanced by Fondo Europeo de Desarrollo Regional (FEDER), No. PI-0076-2017; Consejería de Salud, Junta de Andalucía, No. PI 0128/2018; and Instituto de Salud Carlos III, Ministerio de Sanidad, Acción Estratégica en Salud 2017-2020, No. PI19/01361.
Conflict-of-interest statement: All authors reported no conflicts.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: José-Antonio Girón-González, MD, PhD, Doctor, Medicina Interna, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Instituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Avda Ana de Viya, s/n, Cádiz 11009, Spain. joseantonio.giron@uca.es
Received: March 6, 2021 Peer-review started: March 6, 2021 First decision: July 27, 2021 Revised: August 2, 2021 Accepted: December 9, 2021 Article in press: December 9, 2021 Published online: January 27, 2022 Processing time: 320 Days and 13.6 Hours
Abstract
Loss of follow-up or reinfections hinder the expectations of hepatitis C eradication despite the existence of highly effective treatments. Moreover, the elimination of the infection does not imply the reversion of those chronic alterations derived from the previous infection by hepatitis C virus (HCV). This review analyzes the risk factors associated with loss to follow-up in diagnosis or treatment, and the possibility of reinfection. Likewise, it assesses the residual alterations induced by chronic HCV infection considering the liver alterations (inflammation, fibrosis, risk of decompensation, hepatocellular carcinoma, liver transplantation) and, on the other hand, the comorbidities and extrahepatic manifestations (cryoglobulinemia, non-Hodgkin lymphoma, peripheral insulin resistance, and lipid, bone and cognitive alterations). Peculiarities present in subjects coinfected with human immunodeficiency virus are analyzed in each section.
Core Tip: The excellent hepatitis C virus (HCV) response to direct acting agents should not obviate certain obstacles to eradicate this pathology, especially the loss to follow-up and the possibility of reinfections. Chronic hepatitis C determines persistent alterations despite the elimination of HCV, such as liver dysfunction and continued risk of decompensation and hepatocarcinoma, especially in subjects treated in advanced stages of the disease. Weight gain after sustained virological response (SVR) may favor liver steatosis, increasing the risk of progression of hepatic disease. The probability of complications after SVR in human immunodeficiency virus coinfected patients is similar to that of those HCV-monoinfected.
