1. Hematological and Genetic Markers in the Rational Approach to Patients With HCV Sustained Virological Response With or Without Persisting Cryoglobulinemic Vasculitis
- Author
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Cecilia Napodano, Cristina Stasi, Monica Monti, Serena Lorini, Umberto Basile, Niccolò Marello, Laura Gragnani, Veronica Santarlasci, Silvia Marri, Francesco Madia, Luisa Petraccia, Anna Linda Zignego, and Francesco Annunziato
- Subjects
Male ,Vasculitis ,0301 basic medicine ,medicine.medical_specialty ,Sustained Virologic Response ,Lymphocytosis ,Viral Hepatitis ,Chromosomal translocation ,Antiviral Agents ,Polymorphism, Single Nucleotide ,Gastroenterology ,Group A ,Translocation, Genetic ,Group B ,Immunoglobulin kappa-Chains ,03 medical and health sciences ,0302 clinical medicine ,Immunoglobulin lambda-Chains ,Recurrence ,Internal medicine ,Genotype ,medicine ,Humans ,Receptor, Notch4 ,Cryoglobulinemic vasculitis ,Aged ,DAA ,Chromosomes, Human, Pair 14 ,Hepatology ,business.industry ,Original Articles ,Hepatitis C, Chronic ,Middle Aged ,Prognosis ,medicine.disease ,030104 developmental biology ,Cryoglobulinemia ,HCV ,genetic markers ,cryoglobulinemic vasculitis ,Monoclonal ,Female ,Original Article ,030211 gastroenterology & hepatology ,medicine.symptom ,Chromosomes, Human, Pair 18 ,business - Abstract
Background and Aims Direct‐acting antivirals (DAAs) usually lead to improvement/remission of cryoglobulinemic vasculitis (CV), although symptoms may persist/recur after a sustained virological response (SVR). We evaluated hematological and genetic markers in patients with HCV‐SVR vasculitis with and without persisting/recurring symptoms to early predict the CV outcome. Approach and Results Ninety‐eight patients with HCV‐CV were prospectively enrolled after a DAA‐induced SVR: Group A: 52 with complete clinical response; Group B: 46 with symptom maintenance/recurrence. Monoclonal B‐cell lymphocytosis, t(14;18) translocation, and abnormal free light chains κ/λ ratios were detected by flow cytometry or nested‐PCR or nephelometry in 4% Group A versus 17% Group B (P = 0.04) patients, 17% Group A versus 40% Group B patients (P = 0.02), and 17% Group A versus 47% Group B (P = 0.003) patients, respectively. At least 1 out of 3 clonality markers was altered/positive in 29% of Group A versus 70% of Group B patients (P
- Published
- 2021