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Long-Term Outcomes of Patients With HCV-Associated Cryoglobulinemic Vasculitis After Virologic Cure.
- Source :
-
Gastroenterology [Gastroenterology] 2018 Aug; Vol. 155 (2), pp. 311-315.e6. Date of Electronic Publication: 2018 Apr 26. - Publication Year :
- 2018
-
Abstract
- Patients with hepatitis C virus-associated cryoglobulinemic vasculitis (HCV-CV) have high rates of clinical remission after treatment with direct-acting antivirals (DAAs), but circulating cryoglobulins persist, and vascular disorders reappear in some patients shortly after DAA treatment ends. We performed a prospective study to assess the long-term clinical and immune system effects of HCV eradication with DAAs in 46 patients with HCV-CV and 42 asymptomatic patients with circulating cryoglobulins. A median of 24 months after DAA treatment (range, 17-41 months), 66% of patients with HCV-CV and 70% of asymptomatic patients with circulating cryoglobulins had an immunologic response, with comparable reductions in cryocrit from 2.6% to 0% (P < .05). However, 20% of patients still had positive test results for cryoglobulins after DAA therapy. Among patients with HCV-CV, 42 (91%) had a clinical response, in that their Birmingham Vasculitis Activity Score (version 3) decreased from 7 to 0 (P < .01). Nevertheless, within 2 years after a sustained viral response to DAA therapy, 5 patients with HCV-CV (11%, 4 with cirrhosis) had relapses of vasculitis that included severe organ damage and death.<br /> (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Cryoglobulinemia immunology
Cryoglobulinemia mortality
Cryoglobulinemia virology
Cryoglobulins immunology
Female
Follow-Up Studies
Hepacivirus drug effects
Hepacivirus isolation & purification
Hepatitis C, Chronic drug therapy
Hepatitis C, Chronic immunology
Hepatitis C, Chronic virology
Humans
Male
Middle Aged
Prospective Studies
Recurrence
Sustained Virologic Response
Time Factors
Vasculitis immunology
Vasculitis mortality
Vasculitis virology
Antiviral Agents therapeutic use
Cryoglobulinemia blood
Cryoglobulins analysis
Hepatitis C, Chronic blood
Vasculitis blood
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0012
- Volume :
- 155
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 29705529
- Full Text :
- https://doi.org/10.1053/j.gastro.2018.04.024