Musculoskeletal disease as an extrahepatic manifestation associated with the hepatitis C virus: state of the art

Abstract

Chronic hepatitis C virus infection is recognized as a systemic disease with multiple extrahepatic manifestations that can precede liver damage. Among these, musculoskeletal disease stands out due to its frequency and the functional impact it has on patients. The objective of this narrative review was to analyze the current state of knowledge regarding musculoskeletal disease as an extrahepatic manifestation associated with the hepatitis C virus, considering its pathophysiological mechanisms, clinical scenarios, and therapeutic approaches. A narrative review of scientific literature published between 2019 and 2024 in specialized health sciences databases was conducted. The evidence shows that musculoskeletal manifestations associated with the virus present a broad spectrum, including arthralgia, myalgia, and various patterns of inflammatory arthritis, with complex immunological bases. Furthermore, treatment with direct-acting antivirals not only allows for viral eradication but is also associated with clinical improvement of these manifestations. Timely recognition of musculoskeletal involvement is essential for early diagnosis and comprehensive management of the infection.