Symptomatic and Virological Response to Antiviral Therapy in Hepatitis C Associated with Extrahepatic Complications of Cryoglobulimia |
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Authors: | Supriya Joshi Magdalena Kuczynski E Jenny Heathcote |
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Institution: | (1) Department of Medicine, Toronto Western Hospital, 6B Fell, Room 170, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, USA |
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Abstract: | Mixed cryoglobulins are detected in 50% of patients with hepatitis C; fortunately, few have vasculitis affecting skin, peripheral
nerves, kidneys, and synovia. This study was designed to identify the natural history of symptomatic cryoglobulinemia and
evaluate the response to antiviral therapy. Patients with hepatitis C complicated by symptomatic cryoglobulinemia were assessed
for their disease manifestations and response to antiviral therapy. Of 83 patients identified, 56 patients with a minimum
of 12 months follow-up were reviewed. Manifestations included dermatologic (75%), rheumatologic (57%), neurologic (34%), and
renal (proteinuria 25%). Antiviral therapy was given to 38, of whom 9 were retreated for symptomatic and/or virological nonresponse.
Antiviral therapy included interferon monotherapy (n= 8), pegylated-interferon monotherapy (n= 5), consensus-interferon (n= 2), interferon + ribavirin (n= 18), and pegylated-interferon + ribavirin (n= 14). Treatment provided sustained symptomatic response in 31 (82%) and virological response in 16 (42%) patients. Symptomatic
cryoglobulinemia responds well to antiviral therapy, even when virological response is not achieved. |
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Keywords: | Vasculitis Cryoglobulinemia Hepatitis C Pegylated Interferon Ribavirin |
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