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. 2012 Jun;6(3):606-12.
doi: 10.1007/s12072-011-9303-x. Epub 2011 Aug 19.

Hepatitis C virus (genotype 4)-associated mixed cryoglobulinemia vasculitis: effects of antiviral treatment

Hisham R El Khayat  1 , Yasser M Fouad  2 , Ezzat Ali Ahmad  3 , Hussein El Amin  4 , Faten Ismael  5 , Amal Rizk  6
Affiliations

Hepatitis C virus (genotype 4)-associated mixed cryoglobulinemia vasculitis: effects of antiviral treatment

Hisham R El Khayat et al. Hepatol Int. 2012 Jun.

Abstract

Objective: Type II mixed cryoglobulinemia (MC) is a systemic vasculitis usually associated with hepatitis C virus (HCV). The present trial was performed to investigate the efficacy of therapy with pegylated interferon alfa-2a (PEG-IFN alfa-2a) plus ribavirin in patients with HCV-related MC vasculitis and evaluate the factors associated with clinical remission of MC.

Methods: A total of 46 consecutive patients with HCV-related Type II MC received PEG-IFN alfa-2a (standard dose 180 mg/week) subcutaneously plus oral ribavirin (800-1,200 mg/day) for 48 weeks. The response to treatment was analyzed by comparing clinical, immunologic, and virologic parameters at the initial evaluation with those observed at the end of follow-up. Logistic regression was used to assess the factors associated with clinical remission.

Results: A total of 22 patients (48%) had a sustained virologic response and were complete clinical responders. Serum cryoglobulin disappeared in 26 of 46 patients (56%), and complement levels normalized in 70% of the patients. In univariate analysis, factors associated with complete clinical response were early virologic response at 4 weeks [OR 1.4 (95% CI 0.1-17.1)], proteinuria [OR 1.4 (95% CI 0.2-8.2)] and the fibrosis score [OR 1.09 (95% CI 0.6-1.9)], peripheral neuropathy [OR 0.9 (95% CI 0.1-6.5)], arthralgia [OR 0.7 (95% CI 0.1-3.9)], sicca syndrome [OR 0.6 (95% CI 0.1-3.2)], cryoglobulin [OR 0.2 (95% CI 0.07-1.09)], and purpura [OR 0.1 (95% CI 0.01-1.3)]. In multivariate analysis, only cryoglobulinemia was independently associated with complete clinical response. No patient had side effects for which discontinuation of therapy was required.

Conclusion: The results indicated that treatment with PEG-IFN alfa-2a plus ribavirin can achieve a complete clinical response in patients with HCV-related MC. Complete clinical response correlates with the eradication of HCV.

Keywords: Cryoglobulinemia; Hepatitis C; Interferon.

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References

    1. N Engl J Med. 1994 Mar 17;330(11):751-6 - PubMed
    1. Arthritis Rheum. 2002 Dec;46(12):3317-26 - PubMed
    1. Arthritis Rheum. 2006 Nov;54(11):3696-706 - PubMed
    1. J Rheumatol. 2005 Jun;32(6):1164-7 - PubMed
    1. Blood. 2010 Jul 22;116(3):343-53 - PubMed

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