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HCV Extrahepatic Diseases / Manifestations - kidney, cardiovascular, bone - inflammation - brain - increased mortality
  HCV+ Have Lots of Extra-Hepatic Manifestations & Increased Consequent Mortality: kidney, cardiovascular, brain, inflammation, bone disease, HIV+, cancers, affect on persons on Dialysis....HCV+ have more of these comorbid conditions & SVR has been found to improve conditions
HCV & Kidney Disease, Extra-hepatic Manifestations of HCV - (06/30/14)
Hypertension, proteinuria, and progressive renal failure are the main clinical manifestations of HCV-associated CKD---.......http://cjasn.asnjournals.org/content/4/1/207.long
There is a strong and likely causal association between chronic hepatitis C virus (HCV) infection and glomerular disease, from Jules: IDU may play a strong role in causing kidney disease
HCV & active IDU associated with immune activation - CROI/2016: Understanding the Relative Contributions of IDU and HCV on Systemic Immune Activation...... .....HCV should be aggressively treated in current IDUs even more if HIV and/or HCV positive - (04/4/16) HCV treatment should be aggressive in IDUs because their immune system is activated, immune activation can lead to inflammation which can have poor long-term outcomes, we know that the onset of & early & accelerated & premature onset of comorbidities like heart disease, neurologic impairment, and perhaps kidney disease, bone disease & frailty are all associated with immune activation & to inflammation
Higher prevalence of chronic kidney disease and shorter renal survival in patients with chronic hepatitis C virus infection - (06/30/14)
Higher prevalence of chronic kidney disease and shorter renal survival in patients with chronic hepatitis C virus infection.......this study was conducted in NYC at Metroplitan Hospital which is in East Harlem.....Majority of the included patients were of Hispanic and African-American origin. However, a significant number of the patients in the HCV group had history of IVDU [128 (23.2%)
The Additional Impact of Chronic Kidney Disease on Cardiovascular Outcomes and Death Among HCV Patients.....'kidney disease associated with 60% death increase....patients with HCV+CKD more likely to be Black, more likely to have comorbidities & heart disease'.....http://www.natap.org/2016/EASL/EASL_104.htm from Jules: the impact of not treating HCV+ with a history of drug abuse & IDU clearly is reflected in this study, the long term cost to healthcare system is dismissed when restrictions prevent treating this patient population, it is short-sighted & not cost-effective
Extrahepatic manifestations of hepatitis C virus infection - Review......http://www.natap.org/2006/HCV/042106_01.htm
Fracture risk in hepatitis C virus infected persons: results from the DANVIR cohort study; HIV & HCV/HIV Bone Loss - (03/19/14)
"We conclude that HCV-exposed patients have substantially increased risk of all fracture types, while clearance of HCV only leads to a minor risk reduction. Thus our study suggests that fracture risk is multi-factorial and indicate that a direct metabolic effect of HCV-infection on bone mineral density is not the major determinant of fracture risk among HCV-infected individuals......In this large population-based, nationwide cohort study we observed a more than two fold increased risk of fracture in HCV-exposed patients compared to the general population and the risk was equally raised for low-energy and other fracture types. Furthermore the overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection.......http://www.natap.org/2014/HIV/063014_02.htm
IAS/2013: HIV[ART] and HCV infections independently contribute to lower bone mineral density but have different effects on bone turnover markers......http://www.natap.org/2013/IAS/IAS_33.htm
Decreased bone mineral density after therapy with alpha interferon in combination with ribavirin for chronic hepatitis C......http://www.natap.org/2008/HCV/022008_02.htm
A survey among male patients, aged between 31 and 48 years, who had been treated with either IFN alone or IFN plus ribavirin for 12 months, showed that only patients on combination therapy displayed low bone densitometry T-and Z-scores
Effects of chronic liver disease on bone mineral density and bone metabolism markers in postmenopausal women http://www.natap.org/2005/HCV/110705_01.htm
we showed that postmenopausal women with CLD have reduced BMD values compared with healthy postmenopausal women..... With the use of DEXA at four bone sites, we demonstrated a higher prevalence (72%) of osteoporosis in postmenopausal women with chronic liver disease than healthy postmenopausal women (33%).....
CROI/2016: Hepatitis C and the Risk of Non-Liver-Related Morbidity and Mortality in HIV+ Persons....kidney, bone, cardiovascular
- (04/4/16)
HCV increased risk for kidney (2.4 times increased risk), liver, bone, cardiovascular events, liver-related deaths (8.4 times increased risk, and deaths; achieving SVR vs non achieving SVR reduced the risk for kidney disease on average from a 3.6 times increased risk by 200% to almost normal [1.2 times risk] see Figure 3, SVR vs no SVR reduced risk for cardiovascular disease by 100%, and of course liver disease and death (Table 2)
HCV SVR Improves Quality of Life & Brain Function.....http://www.natap.org/2012/HCV/012712_02.htm this study provides a substantial link between HCV and cerebral dysfunction by demonstrating a reduction in spectroscopic markers of cerebral inflammation and an improvement in cognition, following HCV eradication. While further larger-scale studies are required to confirm these findings, the cerebral benefit of HCV clearance should be recognized and considered an integral part of any anti-viral therapy dialog. SVRs demonstrated significant improvements in verbal learning, memory, and visuo-spatial memory
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 - (07/19/12)
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.
The Impact of Chronic Hepatitis C Virus Infection on Mortality - Editorial - (07/19/12) These data raise important public health issues. HCV infections commonly progress slowly in many chronically infected patients. Nevertheless, they are an important cause of mortality in the United States and worldwide. However, many patients with chronic HCV infections are never identified.
Increased incidence of cancer and cancer-related mortality among persons with chronic hepatitis C infection, 2006-2010 - (09/18/15)
The incidence of NHL was higher in the HCV-infected group (1.6 [1.2-2.1]), a cancer that is not associated with smoking or alcohol use, but has been associated with HIV....The incidence of the following cancers was significantly higher among patients with chronic HCV infection: liver (SRR, 48.6 [95% CI, 44.4-52.7]), pancreas (2.5 [1.7-3.2]), rectum (2.1 [1.3-2.8]), kidney (1.7 [1.1-2.2]), non-Hodgkin lymphoma (NHL) (1.6 [1.2-2.1]), and lung (1.6 [1.3-1.9]). Age-adjusted mortality was significantly higher among patients with: liver (RR, 29.6 [95% CI, 29.1-30.1]), oral (5.2 [5.1-5.4]), rectum (2.6 [2.5-2.7]), NHL (2.3 [2.2-2.31]), and pancreatic (1.63 [1.6-1.7]) cancers. The mean ages of cancer diagnosis and cancer-related death were significantly younger among CHeCS HCV cohort patients compared to the general population for many cancers.
HCV Extrahepatic Mortality-kidney/heart/cancers - 7 studies (06/01/14)
Hepatitis C virus viremia increases the incidence of chronic kidney disease in HIV-infected patients - (09/21/12)
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

Extrahepatic Morbidity and Mortality of Chronic Hepatitis C Review - SVR Clears/Reduces Extrahepatic Manifestations - (11/05/15)
this review discusses the many extra hepatic manifestations of HCV including heart disease, NHL/cancer, neurologic & the brain, touches on kidney disease, mixed cryoglobulinemia (MC)....and describes how SVR reduces or clears these disease and improves overall survival
New Study - SVR Reduces Liver Mortality & Morbidity by 75% and CVD Hospitaliztion by 30%......http://www.natap.org/2015/HCV/090415_05.htm....patients with SVR exhibited >75% reduced risk of liver mortality and SLM (severe liver morbidity), relative to patients without SVR......We report an association between SVR and a 32% risk reduction in non liver mortality.......A second result to emphasize is the association between SVR and a 30% reduction in the risk of hospitalization for CVD, this finding provides further evidence that HCV infection is a risk factor for cardiovascular impairment
Heart Disease in HCV+......http://www.natap.org/2014/HCV/060314_02.htm......HCV+ normotensive patients, in comparison with healthy normotensive subjects, have a significant increase in echocardiographic cardiac mass, totally similar to that observed in hypertensive patients.......IR/hyperinsulinemia HCV-related, by affecting cardiac remodeling, suggests considering chronic HCV infection as a possible new factor in the global cardiovascular risk burden
Hepatitis C Virus Infection is Associated With Increased Cardiovascular Mortality: A Meta-analysis of Observational Studies - (09/22/15)
"This meta-analysis of aggregate data from 22 studies shows that compared to uninfected controls, HCV-infected individuals have increased risks of CVD-related mortality and subclinical carotid atherosclerosis.....To our knowledge, our meta-analysis clearly highlights, for the first time, that HCV infection increases the risk of CVD-related mortality.......clinical studies have shown a higher prevalence of metabolic disorders that are CVD risk factors, specifically type 2 diabetes mellitus (DM) [9], insulin resistance [10], and hepatic steatosis [11], in HCV patients compared to uninfected controls. Moreover, recent data have identified HCV infection as a risk factor for subclinical [12-26] and clinical cardiovascular alterations [27-45].
HCV Transmission & Dialysis - (09/25/15)
Hepatitis C virus infection: a risk factor for Parkinson's disease - (09/22/15)

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