Tailored Treatment Best for Treating HCV Associated Mixed Cryoglobulinemia Vasculitis

HealthDay News — Interferon-free direct-acting antiviral (DAA) therapy is beneficial for hepatitis C virus (HCV)-associated mixed cryoglobulinemia (MC) vasculitis, according to a study published online in Hepatology.

Laura Gragnani, PhD, from the University of Florence in Italy, and colleagues conducted a prospective evaluation of the efficacy and safety of sofosbuvir-based DAA therapy, individually tailored according to the latest guidelines. The evaluation was conducted in a cohort of 44 patients with HCV-associated MC.

The researchers found that MC had evolved into an indolent lymphoma with monoclonal B cell lymphocytosis in two patients. All patients had negative HCV viremia at weeks 12 and 24 post-treatment; all had clinical response of vasculitis at this point. There were significant decreases in the mean Birmingham Vasculitis Activity Score from baseline through 24 weeks; significant decreases were also seen in the mean cryocrit value. Partial clinical response of vasculitis and about a 50% decrease of cryocrit were seen in the two patients with MC and lymphoma, although none experienced a significant decrease in monoclonal B cell lymphocytosis. Fifty-nine percent of patients had adverse events, although they were generally mild.

“Interferon-free, guideline-tailored therapy with DAA is highly effective and safe for HCV-associated MC patients,” the authors write. “The overall 100 percent rate of clinical response of vasculitis, on an intention-to-treat basis, opens the perspective for curing the large majority of these so far difficult-to-treat patients.”


1.Gragnani L, Visentini M, Fognani E, et al. Prospective Study of Guideline-Tailored Therapy with Direct-Acting Antivirals for Hepatitis C Virus-Associated Mixed Cryoglobulinemia. Hepatology. 2016; DOI: 10.1002/hep.28753.