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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.