A systematic review on HCV extrahepatic manifestations in the Asian population

Abstract

The primary manifestation of hepatitis C is usually hepatotropic; however, it is also associated with a wide range of extrahepatic manifestations, which may affect certain specific organs or multiple organ systems. The symptoms, including metabolic problems, autoimmune illnesses, lymphoproliferative ailments, renal and cardiovascular consequences, and dermatological concerns, significantly increase the total disease burden of hepatitis C. This complicates clinical care and needs a comprehensive and individualized therapeutic strategy to address afflicted individuals' various and linked health issues. HCV extrahepatic manifestations are well-known in Western countries and other developed countries; however, the prevalence of extrahepatic diseases in Southeast Asia is still limited. This systematic review initially investigated the prevalence and patterns of extrahepatic manifestations in HCV-infected individuals in Southeast Asia. However, there was limited literature on the topic in the region; therefore, the scope was widened to include East Asia. The systematic literature review was guided by PRISMA and formulated by PICO: ‘P’ for Problem or Population, ‘I’ for Interest, ‘Co’ for Context, and ‘O’ for Outcome. After a comprehensive identification and screening of articles, 12 cohort studies, 7 case reports, and one cross-sectional study were selected from Taiwan, Japan, China, Korea, and other multiple countries. The total sample size of the selected article is 255,340 HCV patients, of whom 11,955 exhibited extrahepatic manifestations. Data on the prevalence, disorder, and specific manifestations of extrahepatic manifestations of hepatitis C were analyzed. The analysis focused on the prevalence, disorder, and specific manifestations of extrahepatic manifestations of hepatitis C. The overall prevalence of extrahepatic manifestations stands at 21.69%. Hypertensive cardiovascular disease affected 4,616 HCV patients, showing a prevalence rate of approximately 38.61%. This was followed by hyperlipidemia at 25.39%, diabetes at 23.22%, and chronic kidney disease at 14.60%. A large number of reports originated from Taiwan; however, there is a significant lack of data from Southeast Asia, which highlights a critical gap in regional research that needs to be addressed. Additionally, the data indicates that men (4624) exhibited a greater propensity for developing extrahepatic complications compared to women (4098). Factors that may be associated include underlying disease, smoking, sex, and body mass index. However, there is a lack of information regarding HCV genotype in relation to EHM. In conclusion, this review underscores the systemic impact of HCV infection and should be considered in the evaluation of the disease within clinical management practices. The geographical and gender disparities in the data highlight the necessity for additional research focused on underrepresented populations, especially in Southeast Asia, to enhance our understanding and treatment strategies for HCV-related complications.