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Review
. 2021 Apr 7;27(13):1267-1282.
doi: 10.3748/wjg.v27.i13.1267.

Metabolic complications of hepatitis C virus infection

Rahul Chaudhari  1 , Sherouk Fouda  2 , Ashik Sainu  3 , Joseph M Pappachan  4
Affiliations
Review

Metabolic complications of hepatitis C virus infection

Rahul Chaudhari et al. World J Gastroenterol. .

Abstract

Hepatitis C virus (HCV) infection is a systemic disease that is implicated in multiple extrahepatic organ dysfunction contributing to its protean manifestations. HCV is associated with diverse extrahepatic disorders including atherosclerosis, glucose and lipid metabolic disturbances, alterations in the iron metabolic pathways, and lymphoproliferative diseases over and above the traditional liver manifestations of cirrhosis and hepatocellular carcinoma. The orchestration between HCV major proteins and the liver-muscle-adipose axis, poses a major burden on the global health of human body organs, if not adequately addressed. The close and inseparable associations between chronic HCV infection, metabolic disease, and cardiovascular disorders are specifically important considering the increasing prevalence of obesity and metabolic syndrome, and their economic burden to patients, the healthcare systems, and society. Cellular and molecular mechanisms governing the interplay of these organs and tissues in health and disease are therefore of significant interest. The coexistence of metabolic disorders and chronic hepatitis C infection also enhances the progression to liver fibrosis and hepatocellular carcinoma. The presence of metabolic disorders is believed to influence the chronicity and virulence of HCV leading to liver disease progression. This comprehensive review highlights current knowledge on the metabolic manifestations of hepatitis C and the potential pathways in which these metabolic changes can influence the natural history of the disease.

Keywords: Cardiovascular diseases; Chronic hepatitis C infection; Diabetes mellitus; Fatty liver; Insulin resistance; Metabolic syndrome.

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Conflict of interest statement

Conflict-of-interest statement: Dr. Pappachan and co-authors of this paper have nothing to disclose.

Figures

Figure 1
Figure 1
Changes in liver, adipose tissue, and muscle with hepatitis C virus infection. Adv: Advanced; HCV: Hepatitis C virus; IR: Insulin resistance.
Figure 2
Figure 2
Hepatic steatosis development in hepatitis C virus infection. Adv: Advanced; HCV: Hepatitis C virus; NAFLD: Non-alcoholic fatty liver disease; FFA: Free fatty acid; IR: Insulin resistance; HCC: Hepatocellular carcinoma.
Figure 3
Figure 3
Impact of hepatitis C virus on glucose and lipid metabolism.
See this image and copyright information in PMC

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