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HCV Extrahepatic Mortality-kidney/heart/cancers
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extra-hepatic manifestations......Presence of HCV may potentially accelerate the disease process in heart disease, 5-7 diabetes, 8,9 various malignancies, 10,11 and genitourinary conditions. 12,13
http://www.natap.org/2014/HCV/021114_03.htm
The Impact of Chronic Hepatitis C Virus Infection on Mortality - due to hepatic & extrahepatic diseases......The overall mortality for those who were HCV RNA positive was increased; the hazard ratio (HR) for mortality after 16.2 years of follow-up was 1.89 (1.66-2.15) for all causes. The HR for hepatic death was 12.48 (9.34-16.66), and the HR for extra hepatic deaths was 1.35 (1.15-1.59). Of interest, there was significantly increased mortality from circulatory disease and several cancers in subjects with active HCV infection.........there is evidence of increased mortality from nonliver-related deaths as well. The other causes of death include renal failure and cardiovascular deaths, likely from chronic inflammation.....The HCV-infected patients were more frequently alcohol or drug abusers and more likely to have renal failure and anemia
http://www.natap.org/2012/HCV/071912_02.htm
Hepatitis C virus viremia increases the incidence of chronic kidney disease in HIV-infected patients.....In conclusion, in the EuroSIDA observational HIV cohort, we have shown that chronic, but not resolved HCV infection, was associated with an increased risk of CKD compared with HIV-monoinfected patients......http://www.natap.org/2012/HIV/092112_01.htm
Hepatitis C Co-infection and the Risk of Chronic Kidney Disease in HIV-infected Individuals:
Does Hepatitis C Viremia Matter? ......http://www.natap.org/2013/CROI/croi_155.htm
HCV Drives Down Kidney Function......http://www.natap.org/2009/HCV/110109_02.htm
Chronic Hepatitis C Virus Infection Increases Mortality From Hepatic and Extrahepatic Diseases: A Community-Based Long-Term Prospective Study - (R.E.V.E.A.L.)-HCV study......http://www.natap.org/2012/HCV/071912_01.htm
"Our findings indicate that anti-HCV seropositives with detectable serum HCV RNA had an elevated mortality from several extrahepatic diseases, whereas the risk for anti-HCV seropositives with undetectable HCV RNA had mortality rates much similar to those seronegative for anti-HCV.......We have reported that HCV infection was associated with cerebrovascular death after considering for conventional risk factors........HCV infection may play as a stimulus for atherothrombosis by triggering a cascade of immune and inflammatory responses, either locally within vascular tissue or systematically through inflammatory mediators [22]......Anti-HCV seropositives, particularly anti-HCV seropositives with positive HCV RNA, had an increased risk of dying from renal diseases compared with anti-HCV seronegatives......In addition to hepatocellular carcinoma, this study found significant associations between HCV infection and increased mortality from cancers of the esophagus, prostate, and thyroid."
from Jules: this study found if a person had HCV with detectable viral load which almost everryone does, risk for death due to liver related disease increased a lot, risk for extrahepatic disease (kidney, cancers, heart disease, circulatory diseases increased. THIS notion is something that clnicians often in the past never told their patients, patients were told 'you can delay therapy, in fact maybe you don't ever have to be treated. But its clear, always has been to me & to some others that there is a real risk for developing extrahepatic diseases & this study found this increases risk for death!!!! Very important, the message is to get cured.
anti-HCV seropositives had higher mortality from both hepatic and extrahepatic diseases, showing multivariate-adjusted hazard ratio (95% confidence interval) of 1.89 (1.66-2.15) for all causes of death; 12.48 (9.34-16.66) for hepatic diseases; 1.35 (1.15-1.57) for extrahepatic diseases; 1.50 (1.10-2.03) for circulatory diseases; 2.77 (1.49-5.15) for nephritis, nephrotic syndrome, and nephrosis; 4.08 (1.38-12.08) for esophageal cancer; 4.19 (1.18-14.94) for prostate cancer; and 8.22 (1.36-49.66) for thyroid cancer. Anti-HCV seropositives with detectable HCV RNA levels had significantly higher mortality from hepatic and extrahepatic diseases than anti-HCV seropositives with undetectable HCV RNA.
"The mortality rate of extrahepatic diseases per 100 000 person-years was 671.6 for anti-HCV seronegatives and 1054.8 for anti-HCV seropositives. Among the extrahepatic causes of death, 1383 (68.5%) and 124 (69.3%) were noncancer deaths for participants seronegative and seropositive for anti-HCV, respectively. The mortality rates per 100 000 person-years for extrahepatic noncancer causes were 459.8 for anti-HCV seronegatives and 730.7 for anti-HCV seropositives with an multivariate-adjusted HR (95% CI) of 1.38 (1.15-1.16). Participants seropositive for anti-HCV had a higher risk of dying from circulatory diseases and renal diseases with a multivariate-adjusted HR (95% CI) of 1.50 (1.10-2.03) and 2.77 (1.49-5.15), respectively, compared with anti-HCV-seronegative participants."
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