Chronic Obstructive Pulmonary Disease and Hepatitis C

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Chronic obstructive pulmonary disease (COPD) is a preventable, treatable disease with significant extrapulmonary manifestations that could affect negatively its course in some patients. Hepatitis C virus infection (HCV), on the other hand, is associated with a number of extrahepatic manifestations. COPD patients have increased prevalence of HCV and patients with HCV, especially older ones, have increased prevalence and faster progression of COPD. HCV infection exerts long-term effects on lung tissue and is an additional risk factor for the development of COPD. The presence of HCV is associated with an accelerated loss of lung function in COPD patients, especially in current smokers. COPD could represent extrahepatic manifestation associated with HCV infection. The aim of this article was to review the literature on prevalence of HCV in COPD and vice versa, pathogenetic link and the consequences of their mutual existence.

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  • 1. From the Global Strategy for the Diagnosis Management and Prevention of COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016. Available from:

  • 2. Pavlov P Ivanov Y Glogovska P et al. COPD morbidity among smokers – an epidemiological study. Thoracic medicine 2011;3(2):50-3.

  • 3. Adeloye D Chua S Lee C et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health 2015;5(2):020415.

  • 4. Bulgarian clinical practice guidelines on the diagnosis management and treatment of chronic hepatitis C 2015.

  • 5. Mohd Hanafiah K Groeger J Flaxman AD et al. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology 2013;57:1333-42.

  • 6. Wasley A Alter MJ. Epidemiology of hepatitis C: geographic differences and temporal trends. Semin Liver Dis 2000;20(1):1-16.

  • 7. Zignego AL Ferri C Pileri SA et al. Extrahepatic manifestations of hepatitis C virus infection: a general overview and guidelines for a clinical approach. Dig Liver Dis 2007;39(1):2-17.

  • 8. Kanazawa H Hirata K Yoshikawa J. Accelerated decline of lung function in COPD patients with chronic hepatitis C virus infection: a preliminary study based on small numbers of patients. Chest 2003;123(2):596-9.

  • 9. Moorman J Saad M Kosseifi S et al. Hepatitis C virus and the lung: implications for therapy. Chest 2005;128(4):2882-92.

  • 10. Erol S Saglam L Ozbek A et al. Hepatitis C virus infection and chronic obstructive pulmonary disease. Hepatitis Monthly 2009;9(1):39-44.

  • 11. Silva DR Stifft J Cheinquer H et al. Prevalence of hepatitis C virus infection in patients with COPD. Epidemiol Infect 2010;138(2):167-73.

  • 12. El-Habashy M Eldahdouh S Mohamed A. The impact and effect of liver insufficiency of HCV infection on patients with chronic obstructive pulmonary diseases. Egyptian Journal of Chest Diseases and Tuberculosis 2014;63:81-5.

  • 13. Yigit I Hacievliyagil S Seckin Y et al. The relationship between severity of liver cirrhosis and pulmonary function tests. Dig Dis Sci 2008;53(7):1951-6.

  • 14. Buist A McBurnie M Vollmer W et al. International variation in the prevalence of COPD (the BOLD study): a population-based prevalence study. Lancet 2007;370(9589):741-50.

  • 15. Butt A Khan U McGinnis K et al. Co-morbid medical and psychiatric illness and substance abuse in HCV-infected and uninfected veterans. J Viral Hepat 2007;14(12)890-6.

  • 16. Minakata Y Sugiura H Yamagata T et al. Prevalence of COPD in primary care clinics: correlation with non-respiratory diseases. Internal Medicine 2008;47(2):77-82.

  • 17. Erturk A Tokgonul A Capan N et al. Pulmonary alterations in patients with chronic HCV infection. Dig Liver Dis 2006;38(9):673-6.

  • 18. Minakata Y Ueda H Akamatsu K et al. High COPD prevalence in patients with liver disease. Internal Medicine 2010;49(24):2687-91.

  • 19. Mapel D Marton J. Prevalence of renal and hepatobiliary disease laboratory abnormalities and potentially toxic medication exposures among persons with COPD. Int J Chron Obstruct Pulmon Dis 2013:8;127-34.

  • 20. Fischer W Drummond M Merlo C et al. Hepatitis C virus infection is not an independent risk factor for obstructive lung disease. COPD 2014;11(1):10-6.

  • 21. Agusti AG. Systemic effects of chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005;2:367-70.

  • 22. Zhu J Kilty I Granger H et al. Gene expression and immunolocalization of 15-lipoxygenase isozymes in the airway mucosa of smokers with chronic bronchitis. Am J Respir Cell Mol Biol 2002;27:666-77.

  • 23. de Boer WI Sont JK van Schadewijk A et al. Monocyte chemoattractant protein 1 interleukin 8 and chronic airways inflammation in COPD. J Pathol 2000;190:619-26.

  • 24. Wagoner J Austin M Green J et al. Regulation of CXCL-8 (interleukin-8) induction by double-stranded RNA signaling pathways during hepatitis C virus infection. J Virol 2007;81:309-18.

  • 25. Koo BC McPoland P Wagoner JP et al. Relationships between hepatitis C virus replication and CXCL-8 production in vitro. J Virol 2006;80:7885-93.

  • 26. Moorman JP Fitzgerald SM Prayther DC et al. Induction of p38- and gC1qR-dependent IL-8 expression in pulmonary fibroblasts by soluble hepatitis C core protein. Respir Res 2005;6:105.

  • 27. Jeffery PK. Remodeling in asthma and chronic obstructive lung disease. Am J Respir Crit Care Med 2001;164:S28-S38.

  • 28. Fujimura M Myou S Nomura M et al. Interleukin-8 inhalation directly provokes bronchoconstriction in guinea pigs. Allergy 1999;54:386-91.

  • 29. Kaplanski G Farnarier C Payan MJ et al. Increased levels of soluble adhesion molecules in the serum of patients with hepatitis C: correlation with cytokine concentrations and liver inflammation and fibrosis. Dig Dis Sci 1997;42:2277-84.

  • 30. Polyak SJ Khabar KS Rezeiq M et al. Elevated levels of interleukin-8 in serum are associated with hepatitis C virus infection and resistance to interferon therapy. J Virol 2001;75:6209-11.

  • 31. Mahmood S Sho M Yasuhara Y et al. Clinical significance of intrahepatic interleukin-8 in chronic hepatitis C patients. Hepatol Res 2002;24:413-9.

  • 32. Shimoda K Begum NA Shibuta K et al. Interleukin-8 and hIRH (SDF1-/PBSF) mRNA expression and histological activity index in patients with chronic hepatitis C. Hepatology 1998;28:108-15.

  • 33. Kubo K Yamaguchi S Fujimoto K et al. Bronchoalveolar lavage fluid findings in patients with chronic hepatitis C virus infection. Thorax 1996;51:312-4.

  • 34. Yamaguchi S Kubo K Fujimoto K et al. Analysis of bronchoalveolar lavage fluid in patients with chronic hepatitis C before and after treatment with interferon. Thorax 1997;52:33-7.

  • 35. Idilman R Cetinkaya H Savas I et al. Bronchoalveolar lavage fluid analysis in individuals with chronic hepatitis C. J Med Virol 2002;66:34-9.

  • 36. Lukacher AE Braciale VL Braciale TJ. In vivo effector function of influenza virus-specific cytotoxic T lymphocyte clones is highly specific. J Exp Med 1984;160:814-26.

  • 37. Fabbri LM Romagnoli M Corbetta L et al. Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003;167:418-24.

  • 38. Adamko DJ Fryer AD Bochner BS et al. CD8+ T lymphocytes in viral hyperreactivity and M2 muscarinic receptor dysfunction. Am J Respir Crit Care Med 2003;167:550-6.

  • 39. Jacoby DB Xiao HQ Lee NH et al. Virus- and interferon-induced loss of inhibitory M2 muscarinic receptor function and gene expression in cultured airway parasympathetic neurons. J Clin Invest 1998;102:242-8.

  • 40. Raynaud C Roche N Chouaid C. Interactions between HIV infection and chronic obstructive pulmonary disease: Clinical and epidemiological aspects. Respiratory Research 2011;12:117.

  • 41. Hull MW Phillips P Montaner JS. Changing global epidemiology of pulmonary manifestations of HIV/AIDS. Chest 2008;134:1287-98.

  • 42. Magalhaes MG Greenberg B Hansen H et al. Comorbidities in older patients with HIV: a retrospective study. J Am Dent Assoc 2007;138:1468-75.

  • 43. Rodriguez-Roisin R Krowka MJ. Hepatopulmonary syndrome – a liver-induced lung vascular disorder. N Engl J Med 2008;358:2378-87.

  • 44. Lange PA Stoller JK. The hepatopulmonary syndrome. Ann Intern Med 1995;122:521-9.

  • 45. Yen KT Krowka MJ Lee AS et al. Liver and lung: hepatopulmonary syndrome. J Crit Illness 2002;17:309-15.

  • 46. Herve P Lebrec D Brenot F et al. Pulmonary vascular disorders in portal hypertension. Eur Respir J 1998;11:1153-66.

  • 47. Rodriguez-Roisin R Krowka MJ Herve P et al. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004;24(5):861-80.

  • 48. Hadengue A Benhayoun MK Lebrec D et al. Pulmonary hypertension complicating portal hypertension: prevalence and relation to splanchnic hemodynamics. Gastroenterology 1991;100:520-8.

  • 49. Kuo PC Plotkin JS Johnson LB et al. Distinctive clinical features of portopulmonary hypertension. Chest 1997;112:980-6.

  • 50. Sangal R Taylor L Gillani F et al. Risk of echocardiographic pulmonary hypertension in individuals with human immunodeficiency virus-hepatitis C virus coinfection. Ann Am Thorac Soc 2014;11:1553-9.

  • 51. Aisa Y Yokomori H Kashiwagi K et al. Polymyositis pulmonary fibrosis and malignant lymphoma associated with hepatitis C virus infection. Intern Med 2001;40:1109-12.

  • 52. Davis GL Balart LA Schiff ER et al. Treatment of chronic hepatitis C with recombinant interferon: a multicenter randomized controlled trial. Hepatitis Interventional Therapy Group. N Engl J Med 1989;321:1501-6.

  • 53. Abi-Nassif S Mark EJ Fogel RB et al. Pegylated interferon and ribavirin-induced interstitial pneumonitis with ARDS. Chest 2003;124:406-10.

  • 54. Fruehauf S Steiger S Topaly J et al. Pulmonary artery hypertension during interferon therapy for chronic myelogenous leukemia. Ann Hematol 2001;80:308-10.

  • 55. Rubinowitz AN Naidich DP Alinsonorin C. Interferon-induced sarcoidosis. J Comput Assist Tomogr 2003;27:279-83.

  • 56. Takeda A Ikegame K Kimura Y et al. Pleural effusion during interferon treatment for chronic hepatitis C. Hepatogastroenterology 2000;47:1431-5.

  • 57. Karino Y Hige S Matsushima T et al. [Interstitial pneumonia induced by interferon therapy in type C hepatitis.] Nippon Rinsho 1994;52:1905-9 (Japanese).

  • 58. Okanoue T Sakamoto S Itoh Y et al. Side effects of high-dose interferon therapy for chronic hepatitis C. J Hepatol 1996;25:283-91.

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