Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12372
Revised: March 23, 2014
Accepted: June 20, 2014
Published online: September 21, 2014
The association of chronic hepatitis C with immune related syndromes has been frequently reported. There is a great range of clinical manifestations affecting various systems and organs such as the skin, the kidneys, the central and peripheral nervous system, the musculoskeletal system and the endocrine glands. Despite the high prevalence of immune related syndromes in patients with chronic hepatitis C, the exact pathogenesis is not always clear. They have been often associated with mixed cryoglobulinemia, a common finding in chronic hepatitis C, cross reaction with viral antigens, or the direct effect of virus on the affected tissues. The aim of this review is to analyze the reported hepatitis C virus immune mediated syndromes, their prevalence and clinical manifestations and to discuss the most supported theories regarding their pathogenesis.
Core tip: Autoimmune manifestations appear with an elevated prevalence in hepatitis C virus (HCV) patients. Despite their frequency, the pathophysiology of most of these syndromes is not adequately elucidated. We searched thoroughly through the available data and provided a summary of variable clinical manifestations and immune mediated diseases presenting during chronic HCV infection. The differences between HCV-related autoimmune syndromes and other similar autoimmune diseases have been cited. Moreover, we listed and critically analyzed the most supported theories regarding their pathogenesis.