Extrahepatic comorbidities associated with hepatitis C virus in HIV-infected patients

PURPOSE OF REVIEW: HIV infection facilitates progression of hepatitis C virus (HCV)-related liver fibrosis, thus increasing the risk of cirrhosis and decompensated liver disease. Although the primary target of HCV infection is the liver, extrahepatic manifestations related to HCV contribute significantly to morbidity and mortality in patients with chronic hepatitis C. We review current data on extrahepatic comorbidities associated with HCV in HIV-infected patients. RECENT FINDINGS: A large proportion of individuals coinfected with HIV/HCV has extrahepatic manifestations that may be indirectly or directly related to HCV infection. Extrahepatic manifestations include autoimmune and/or lymphoproliferative disorders, and cardiovascular, renal, metabolic, and central nervous system manifestations. Chronic immune activation and systemic inflammation, hallmarks of both HIV and HCV infection, may contribute greatly to extrahepatic comorbidities of HCV in this population group. There is substantial evidence that successful antiviral therapy might reduce both hepatic and extrahepatic manifestations of HCV infection in patients coinfected with HIV/HCV. SUMMARY: A substantial burden of the morbidity and the mortality related to HCV in patients with or without HIV infection depends on its extrahepatic manifestations. HCV eradication following successful antiviral therapy might reduce both.