John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Hepatic and extra-hepatic manifestions due to hepatitis C virus infection Volume 19, issue 8, Octobre 2012

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Hospices Civils de Lyon, service d’hépatologie, 69004 Lyon, France ; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, F-69003 Lyon, France

HCV infection is a frequent chronic viral infection with more than 220.000 cases in France. Its prevalence is about 0.84% (IC: 0.66-1.10). It is a leading cause of cirrhosis, liver failure, hepatocarcinoma and a major public health problem especially in exposed subjects. Risks factors have been identified allowing screening programs. Hepatic manifestations are not very specific to HCV but reflects severe liver damage. The course of chronic hepatitis C is highly variable leading to increasing fibrosis and cirrhosis and its complications. The limitations of liver biopsy have stimulated research for non invasive approaches for assessment of fibrosis which remains warranted. Several serum marker tests are currently widely used for hepatitis C. Transient elastography is also available for the measure of liver stifness. Assessment of significant fibrosis allows defining a risk-population submitted to surveillance program. Extra hepatic manifestations such as cryoglobulinemia, systemic disorders and lymphoma are linked to HCV. They are polymorph and affect quality of life. The aim of this review is to resume the biological endpoints, clinical outcome, how to assess liver damage, and how to check for extrahepatic manifestations. A better knowledge of extrahepatic manifestations and there physiopathothology might be helpful to increase efficacy of therapy.