학술논문
A Systematic Review of the Extrahepatic Manifestations of Hepatitis C Infection in East Asia
Document Type
Article
Author
Source
춘·추계 학술대회(The Liver Week). Jun 16, 2018 2018(1):161
Subject
Language
Korean
Abstract
Aims: Chronic hepatitis C (CHC) infection causes a systemic infection with hepatic and extrahepatic manifestation (EHMs). Although the prevalence of EHMs in Western countries is well described, the same is not well known in East Asian countries. We performed a systematic review to quantify the prevalence of selected EHMs among CHC patients in East Asia. Methods: PubMed, Medline, and Japan databases searched (1990-Dec 2016) with “hepatitis c virus” “chronic hepatitis C”, “extrahepatic manifestations”, and respective EHM’s. Data were collected and reviewed by two per PRISMA guidelines. EHMs were by ICD-9 codes or clinically: depression:BDI-2 score>19, chronic kidney disease (CKD): eGFR of < 60 mL/ min/1.73 m2 per MDRD, diabetes (DM):fasting blood glucose level > 126 mg/dL. Pooled prevalence determined by random effects models. Results: 75 articles were identified. After applying inclusion and exclusion criteria, 23 articles remained (Japan=6; China=3, Korea= 4, Taiwan=9, Asia=1) with a total of 468,656 subjects (n= 51,160 CHC and n= 417,496 non-HCV controls). HCV patient age ranged from 44-70 (mean age 55), 50% were male (range 0%-67%), and over 80% of diagnosis was established through positive HCV anti-body. CHC subjects had higher risk of lymphoma (n=2) 4.6% vs. 2.3%, OR=1.79 (1.47-2.19), P<0.0001; DM (n=11) 16.7% vs. 9.4%, OR=1.84 (1.52-2.21), P<0.0001; SS (n=2) 9.6% vs. 3.5%, OR=9.80 (1.25-76.56), P=0.0295; LP (n=5) 8.2% vs. 4.2%, OR=2.45 (1.36-4.41), P=0.0027; depression (n=1) 51.6% vs. 27.7%, OR=2.77 (1.25-6.15), P=0.0121; CKD (n=5) 3.8% vs. 1.7%, OR=2.00 (1.09-3.70), P=0.026; RA (n=2) 0.9% vs. 0.3%, OR=2.41 (1.54-3.76), P=0.0001; CVA (n=2) 25.3% vs. 19.3%, hazard ratio 1.38 (1.24-1.53), P<0.05; IHD (n=1) 25.3% vs 11.6%, OR=1.76 (1.04-2.96), P=0. 0.034. Additionally, the prevalence of MC (symptomatic and asymptomatic; n=1) in CHC was 46.9% in CHC vs. 1.9% in general population with a risk ratio of 24.7 (17.2-32.2). Conclusions: Our review found that CHC in East Asia is associated with increased risk for EHMs.