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Review
. 2022 Jan 27;14(1):62-79.
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  1 , Mercedes Márquez-Coello  1 , Francisco Illanes-Álvarez  1 , Denisse Márquez-Ruiz  1 , Ana Arizcorreta  1 , Fátima Galán-Sánchez  2 , Natalia Montiel  2 , Manuel Rodriguez-Iglesias  2 , José-Antonio Girón-González  3
Affiliations
Review

Hepatitis C: Problems to extinction and residual hepatic and extrahepatic lesions after sustained virological response

Sara Cuesta-Sancho et al. World J Hepatol. .

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.

Keywords: Cirrhosis decompensation; Direct antiviral agents; Extrahepatic complications; Hepatitis C virus; Hepatocarcinoma; Human immunodeficiency virus; Sustained virological response.

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Conflict of interest statement

Conflict-of-interest statement: All authors reported no conflicts.

Figures

Figure 1
Figure 1
Modification of hepatic and extrahepatic manifestations of chronic hepatitis C after therapy with direct acting agents. Figure represents the main alterations modified by this treatment, as well as those factors that influence the risk: absence of follow-up, previous fibrosis stage, previous decompensation, ongoing liver injury or liver stiffness after sustained viral response. HCV: Hepatitis C virus; SVR: Sustained virologic response; Kpa: Kilopascals.
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