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Post Info TOPIC: Extrahepatic Manifestations of HCV


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RE: Extrahepatic Manifestations of HCV
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This is old, but is applicable, in regard to "basic info" about "extrahepatic manifestations" and the association between having HCV and developing diabetes or chronic kidney disease. 

(Excerpt) from "Renal and Urology News":

Annette Bruchfeld, MD, PhD

August 15, 2016

 

FEATURE

Hepatitis C in CKD: Challenges and Opportunities

[Editor's note: This review and commentary includes study data presented at the 53rd Congress of the European Renal Association-European Dialysis & Transplant Association (ERA-EDTA 2016) in Vienna, Austria, May 21-24. 2016, and reflects discussions that took place at the congress.]

Infection with the hepatitis C virus (HCV) affects more than 170 million people worldwide. After acute infection, 80% to 85% of individuals do not clear the virus and progress to chronic infection and its associated complications.1 The risk of liver-related complications such as cirrhosis and hepatocellular carcinoma is well known, but it has become apparent that HCV is also associated with extra-hepatic complications, including chronic kidney disease (CKD).

 

... HCV infection increases ESRD risk among patients with diabetes ...

 

HCV and chronic kidney disease

According to a recent systematic review and meta-analysis, individuals who are seropositive for anti-HCV antibodies (HCV+) have a significant 23% greater relative risk of having and/or developing CKD compared with uninfected individuals.2 At the 53rd Congress of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) in Vienna, I advised delegates that chronic HCV infection should be seen as a metabolic disease that causes chronic systemic inflammation through direct viral effects on the vasculature and indirect effects via the immune system and the liver. The result is a pro-inflammatory state that increases the risk of atherosclerosis, cardiovascular disease, the metabolic syndrome, and diabetes.3These are known risk factors for CKD in the general population, but a large cohort study in Taiwan concluded that there is a significant and independent association between HCV and CKD in the absence of traditional CKD risk factors.4

It is now well recognized that HCV is associated with glomerular disease, most commonly membranoproliferative glomerulonephritis with or without cryoglobulinemia. Other reported lesions include membranous nephropathy, focal segmental glomerulosclerosis, fibrillary or immunotactoid glomerulopathies, and thrombotic microangiopathy.5 HCV is thought to cause renal injury through the action of cryoglobulins, HCV-antibody immune complexes, and direct cytopathic effects, including endotheliitis, mesangial inflammation and podocyte injury.6 

Worldwide, diabetes mellitus is the most common cause of end-stage renal disease (ESRD),7and HCV adds to the risk in these patients. In a study, the risk of ESRD was 44% greater in patients with both diabetes and HCV patients than in those without HCV (HCV - ). The risk was 2.0 and 1.8 times as great for patients younger than 50 years and those infected within 4 years of their diabetes diagnosis, respectively.8 The presence of diabetes may therefore be a strong indication for antiviral treatment. A study from Taiwan demonstrated that patients treated for HCV infection had a significant 84% reduction in the risk of ESRD, a significant 47% reduction in the risk of ischemic stroke, and a non-significant 36% reduction in the risk of acute coronary syndromes.9 ...

 

See also:  https://www.hcvguidelines.org/unique-populations/renal-impairment - Treatment of renal patients, where the AASLD guidelines states that HCV is independently associated with the development of CKD, and that worsening of CKD is associated with having HCV.

 

And, as well, of course see: (from bottom) the post/link Tig originally started this thread with (http://hcvadvocate.org/hepatitis/factsheets_pdf/extrahepatic.pdf) for more  extensive listings of "Extrahepatic Manifestations of HCV".



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HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)



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Ok, that list of conditions is enlightening, some in particular. Thanks for the link!

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Lamont Cranston "Only the Shadow knows."

65 years old, retired IT Network support 29 continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Starting EPCLUSA 7/28/17

No Virus Detected on November 20, 2017 3 months after EOT



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Wow, I am a retired nurse and didn't know a third of these things. But I have to admit after three rounds of intron I stuck my head in the sand not wanting to know what I couldn't control. I could cry remembering how many times I thought I was crazy because I was so uncomfortable and in so much pain irregardless of the fact that I have ortho issues since I was a kid. Thank you so much for validating so many of my symptoms.

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God bless Larry


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Excellent find, thanks Tig!       

There's no "like" button but a  will do.    



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Treatment halted on Aug.8,2012 due to vision problem.  6 month post tx labs

Aug.2013 SVR

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I pushed the LIKE button on this one Tig,. Three times!

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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 



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Thanks for posting this here, Tig, very helpful information!  ~ Jill



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Jill 

(68 yo, lives in UK)

Was Gen 3a, 

24wks Peg/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 



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That's an excellent resource.   Lot's of good information.   Thanks for posting that!

 

Sandy



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Hubby profile:  Genotype 1a.  Hep C since late 70's.  Cirrhosis.   Interon/Riba 2x.  Incivek/interf/riba:  Und at 8 weeks, but had to stop due to DRESS syndome.  Olysio/Sovaldi started 6/18/2014.  Cleared virus 11/05/2014

Tig


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An Overview of Extrahepatic Manifestations of Hepatitis C 

http://hcvadvocate.org/hepatitis/factsheets_pdf/extrahepatic.pdf

 

A good source of information in a single pdf article that may help describe and explain some of the signs and symptoms associated with HCV. I thought it would be easier to find this data via our search function if it was set up this way. 

Tig



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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