Thyroid Diseases and Hepatitis C Chronic Infection

Abstract

More than 185 million subjects worldwide are infected by Hepatitis C virus (HCV), and about 20% of patients chronically infected with HCV progress to cirrhosis and 1-2% to hepatocarcinoma [1]. HCV chronic infection is also associated with extrahepatic manifestations in up to 74% of patients (mixed cryoglobulinemia, lymphomas, rheumatic disorders, type 2 diabetes, and thyroid disorders) [2]. For about two decades combination therapy with PEGylated-interferon-α [3] and ribavirin has been the standard of care for patients with HCV chronic infection; however, interferon had limited effectiveness and was associated with important adverse side effects. More recently, advances in understanding the molecular pathways associated with HCV life cycle, and the complex inflammatory network involving cytokines and chemokines associated with HCV chronic hepatitis, have led to important advancements in therapy [4]. In the last years, direct-acting antivirals (DAAs) (as protease inhibitors, polymerase inhibitors, or NS5A inhibitors) have been used to treat HCV chronic infection, resulting in shorter treatment duration, better efficacy and tolerance, and are able to eradicate HCV [5,6].