Click to go to VA site

Providers are told that in cases where there is no “significant extra-hepatic disease” treatment can be deferred.  But they are told NOT to delay treatment, even with mild liver disease, when these are present (Table 12–scroll down). These are the urgent extra-hepatic disorders linked to HCV without reservation:

Leukocytoclastic vasculitis (Medscape images) (foundation)

symptomatic cryoglobulinemia (Medline–images right menu)

membranoproliferative glomerulonephritis (Medline symptoms etc.; Medscape–secondary cause: HCV)

A large VA database 2002 study, Extrahepatic manifestations of hepatitis C among United States male veterans,  compared HCV vets hospitalized from 1992 to 1999 (n = 34,204) with random controls (n=136,816)  and found other complications.  This study has been cited by 34 papers in Pubmed.  Although I’ve only read the abstract, the information is interesting but not current.  HCVets has more current information on extrahepatic conditions their website.  It would be useful to know ALL of the extrahepatic manifestions the VA acknowledges and what “significant” means in the case of each. 

A good 2010 NYU slideshow indicates that a lot of work is being conducted on this topic. The lists are getting so long it’s hard to image anyone with HCV (active or inactive) without at least one known complication.