Extrahepatic Manifestations of Hepatitis C

1. Essential mixed cryogiobulinemia
2. Lymphoma
3. Glomerulonephritis
4. Porphyria cutanea tarda
5. Diabetes mellitus
6. Corneal ulceration
7. Autoimmune phenomena
8. Uveitis
9. Sialadenitis
10. Peripheral neuropathy

The mechanism by which alcohol effects a more rapid progression of disease is not known. The amplification of cytokine signals is believed to play a role in this process by stimulating stellate cells and increasing fibrosis. Alcohol consumption also increases the risk of developing HCC.
Age and gender. Acquisition of hepatitis C after age 40 is associated with a more rapid disease progression. The reasons for this effect are uncertain but may be related to an aging immune system. Male sex is also associated with more rapid disease progression.

Coinfection. Hepatitis C and HIV coinfection appears to lead to rapid progression of liver disease. Progression to cirrhosis or liver failure may occur within 10-15 years after infection with HCV, and this progression occurs at approximately twice the rate as what occurs with hepatitis C infection alone. Hepatitis C and related liver disease are now the leading cause of non-AIDS-associated death in patients with HIV.