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World J Gastroenterol. 2017 Feb 7;23(5):743-750. doi: 10.3748/wjg.v23.i5.743.

Hepatitis C virus-associated pruritus: Etiopathogenesis and therapeutic strategies.

Author information

1
Youssef Alhmada, Mohamed Hassan, Department of Pathology, University of Mississippi Medical Center, Jackson, MS 39216, United States.

Abstract

In addition to its contributing role in the development of chronic liver diseases, chronic hepatitis C virus (HCV) infection is associated with extrahepatic manifestations, particularly, cutaneous-based disorders including those with pruritus as a symptom. Pruritus is frequently associated with the development of chronic liver diseases such as cholestasis and chronic viral infection, and the accumulation of bile acids in patients' sera and tissues as a consequence of liver damage is considered the main cause of pruritus. In addition to their role in dietary lipid absorption, bile acids can trigger the activation of specific receptors, such as the G protein-coupled bile acid receptor (GPBA/ TGR5). These types of receptors are known to play a crucial role in the modulation of the systemic actions of bile acids. TGR5 expression in primary sensory neurons triggers the activation of the transient receptor potential vanilloid 1 (TRPV1) leading to the induction of pruritus by an unknown mechanism. Although the pathologic phenomenon of pruritus is common, there is no uniformly effective therapy available. Understanding the mechanisms regulating the occurrence of pruritus together with the conduction of large-scale clinical and evidence-based studies, may help to create a standard treatment protocol. This review focuses on the etiopathogenesis and treatment strategies of pruritus associated with chronic HCV infection.

KEYWORDS:

Autotoxin; Cholestasis; Hepatitis C virus; Lysophosphatidic acid; PI3 kinase; Pruritus

PMID:
28223719
PMCID:
PMC5296191
DOI:
10.3748/wjg.v23.i5.743
[Indexed for MEDLINE]
Free PMC Article

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