REVIEWS   Free

Minerva Endocrinologica 2015 December;40(4):321-9

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Endocrine manifestations of chronic HCV infection

Caviglia G. P. ¹, Rosso C. ¹, Fagoonee S. ², Cisarò F. ³, Andrealli A. ⁴, Smedile A. ^{1, 3}, Pellicano R. ³ ✉

¹ Department of Medical Sciences, University of Turin, Turin, Italy; ² Institute for Biostructures and Bioimages (CNR), c/o Molecular Biotechnology Center, University of Turin, Turin, Italy; ³ Department of Gastroenterology and Hepatology, Molinette Hospital Turin, Italy; ⁴ Unit of Gastroenterology and Digestive Endoscopy, Valduce Hospital, Como, Italy

Chronic hepatitis C virus (HCV) infection has been associated with a great number of extra-hepatic manifestations (EHMs), including several endocrine disorders. Currently available epidemiological, clinical and experimental data do not show a link between HCV and all EHMs. Thyroid disorders (TD) and type 2 diabetes, for example, are the most frequent endocrine alterations in patients with chronic HCV infection, but there are only weak evidences that HCV could be involved in hypothalamic-pituitary axis perturbation, bone metabolism alteration and sexual dysfunctions induction. Thus, this issue needs further investigation. Prospective studies have also shown that interferon (IFN)-based therapy for chronic HCV infection can induce or worsen EHMs. In particular, IFN has been associated with development of autoimmunity and/or TD in up to 40% of chronic HCV infected patients. Hence, a careful monitoring of thyroid function should be performed in such patients. The recent approval of direct-acting antiviral agents in IFN-free regimens for chronic hepatitis C treatment will dramatically reduce not only liver-related mortality but also morbidity due to EHMs.