Triple antiviral therapy in hepatitis C virus infection with or without mixed cryoglobulinaemia: A prospective, controlled pilot study
| Autor: | Anna Linda Zignego, Elisa Fognani, T. Urraro, Barbara Boldrini, Monica Monti, Laura Gragnani, Giacomo Laffi, Alessia Piluso, Alessio Fabbrizzi, E. Triboli, J. Ranieri, P. Caini |
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| Rok vydání: | 2014 |
| Předmět: |
hepatitis C virus
Adult Male Genotype Proline Hepatitis C virus Pilot Projects Hepacivirus medicine.disease_cause Antiviral Agents Asymptomatic Polyethylene Glycols chemistry.chemical_compound Liver disease Mixed Cryoglobulinemia hemic and lymphatic diseases Boceprevir antiviral therapy Ribavirin Humans Medicine Prospective Studies Aged direct-acting antiviral integumentary system Hepatology business.industry Gastroenterology Antiviral therapy Interferon-alpha Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease Recombinant Proteins Treatment Outcome Cryoglobulinemia chemistry Viral replication Immunology RNA Viral Drug Therapy Combination Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Digestive and Liver Disease. 46:833-837 |
| ISSN: | 1590-8658 |
| DOI: | 10.1016/j.dld.2014.05.017 |
| Popis: | Background Mixed cryoglobulinaemia is strongly related to hepatitis C virus infection. Treatment with peg-interferon and ribavirin has been indicated as first-line therapy for mild/moderate hepatitis C virus-related mixed cryoglobulinaemia. Aim To evaluate the safety and efficacy of triple boceprevir-based antiviral therapy in patients with or without mixed cryoglobulinaemia previously treated with peg-interferon and ribavirin, and with advanced liver disease. Methods Thirty-five hepatitis C virus-positive patients (17 with asymptomatic mixed cryoglobulinaemia, 5 with symptomatic mixed cryoglobulinaemia, and 11 without mixed cryoglobulinaemia) were treated with triple boceprevir-based antiviral therapy. Results In 19/22 cryoglobulinaemic subjects (86%), the addition of boceprevir induced cryocrit disappearance. Cryocrit behaviour was related to virological response, with improvement of symptoms upon undetectable viraemia and reappearance after virological breakthrough. The rate of sustained virological response was lower in cryoglobulinaemic patients than in patients without mixed cryoglobulinaemia (23.8% vs 70% respectively, p = 0.01). Conclusion Boceprevir-based therapy was safe and effective in cryoglobulinaemic patients. The correlation between direct inhibition of hepatitis C virus replication and clinical improvement in mixed cryoglobulinaemic patients is definitive proof of the key pathogenetic role played by viral replication. Further studies are needed to confirm and clarify the reduced virological response in patients with mixed cryoglobulinaemia. |
| Databáze: | OpenAIRE |
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