Mixed cryoglobulinaemia associated with hepatitis C virus infection: A predictor factor for treatment with interferon?

Pellicano, Rinaldo; Marietti, G; Leone, Nicola; Arena, Vincenzo; F, Palmas; Rizzetto, Mario; Ponzetto, Antonio

doi:10.1046/j.1440-1746.1999.02015.x

Cited by 14 publications

(4 citation statements)

References 17 publications

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“…Because of the relationship between hepatitis C and cryoglobulin, the management of the viral infection has been the therapy of choice for treating symptomatic or asymptomatic cryoglobulinemia. Several studies in the literature did not show any difference in the response to the therapy using interferon alpha, among patients with and without cryoglobulins 8,12,24,28,31 . However, the introduction of ribavirin as a therapy option for hepatitis C, modified considerably the therapeutic response observed for patients of this disease, thus requiring a revision of the response-associated factors to the treatment 30 .…”

Section: Discussionmentioning

confidence: 92%

“…The presence of cryoglobulinemia did not appear to influence the response of the hepatitis C treatment when only interferon alpha was utilized 8,24,28 . However, the therapeutic response to the combined treatment of interferon and ribavirin has only been evaluated in the retreatment of non-responsive cases to a previous monotherapy treatment 6,8,22 , or in specific studies of complications of cryoglobulinemia, such as vasculitis or glomerulonephritis 1,4,5,27,37 .…”

Section: Introductionmentioning

confidence: 97%

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Cryoglobulinemia in chronic hepatitis C: clinical aspects and response to treatment with interferon alpha and ribavirin

Parise

Oliveira

Ferraz

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 97%

Cryoglobulinemia in chronic hepatitis C: clinical aspects and response to treatment with interferon alpha and ribavirin

Parise

Oliveira

Ferraz

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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“…48,49 In open-label studies, 55 to 86% of patients with HCV-CV treated with IFNa had clinical improvement, although relapse occurred in 70 to 90% within 6 months of stopping therapy. [50][51][52][53][54][55][56][57] Misiani and colleagues performed a randomized controlled trial in which patients with active HCV-CV received IFNa 3 million units three times weekly for 23 weeks. 58 After 6 months, 15 of 25 patients who received IFNa had undetectable serum HCV RNA as compared with none of the controls.…”

Section: Interferon-alphamentioning

confidence: 99%

Biologic Immunomodulatory Therapies in the Vasculitic Diseases

Langford

2004

Seminars in Respiratory and Critical Care Medicine

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The expanding range of biologic agents capable of modulating the immune response has opened up a new realm for therapeutic exploration in the vasculitic diseases. Partnered with increasing knowledge regarding the mechanisms of vascular inflammation, these agents have raised the question as to whether it may be possible to treat systemic vasculitis syndromes by selectively targeting pathways involved in disease pathogenesis. The action of these agents to directly modulate specific immunologic components offers the potential not only to impact disease activity but also to reduce the risk of morbidity that can result from currently available treatment options. The study of biologic therapies in the vasculitides must, however, be approached with caution because unanticipated effects on disease activity and disease-specific toxicities can occur. The only biologic agent that has currently been shown to have therapeutic efficacy in a systemic vasculitis syndrome is interferon-alpha in the treatment of hepatitis C-associated cryoglobulinemic vasculitis. The use of biologic agents to treat other vasculitides remains investigational. Methodical evaluation of biologic agents prior to their use in general clinical practice is essential to understand their safety and efficacy. Rigorous, standardized investigations may also provide important insights into pathogenesis of the vasculitic diseases.

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“…The method has been described elsewhere [Pellicano et al, 1999]. Brie¯y, blood (20 ml) was collected by antecubital vein puncture into tubes prewarmed to 378C, and left at 378C until clotting was complete.…”

Section: Detection Isolation and Characterisation Of Cryoglobulinsmentioning

confidence: 99%

Mixed cryoglobulinaemia and chronic hepatitis C virus infection: The rheumatic manifestations

Leone

Pellicano

Maiocco

et al. 2001

Journal of Medical Virology

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The prevalence of rheumatologic symptoms in patients with mixed cryoglobulinaemia associated to chronic hepatitis C virus (HCV) infection was investigated. One hundred fourteen patients (96 female, mean age 63.5 years) with chronic HCV infection and cryoglobulinaemia were recruited. The presence, concentration, and type of cryoglobulins were tested by immunofixation. Rheumatoid factor (RF) and antinuclear antibody (ANA) were also measured. Rheumatological related symptoms were investigated by anamnesis and clinical evaluation. HCV genotype was determined by polymerase chain reaction (PCR) with genotype specific primer. Type II cryoglobulinaemia was identified in 39 cases and it was of type III in 58. HCV-RNA genotype was determined in 62 patients: 47 (76%) were infected by genotype1b, 8 (13%) by genotype 2a, while other genotypes were less common. RF and ANA were, respectively, present in 36 (31.5 %) and 4 (3.5 %) patients at low titre (RF < 50 UI/ml, ANA < 1:80). Of the 114 patients, 51 (44.7%) complained for rheumatological symptoms. The mean cryocrit value in these patients was 2,6 %, while in patients with HCV infection, liver disease, and cryoglobulinaemia without rheumatological symptoms the cryocrit value was lower than 0.5% in 50% of cases. It is concluded that patients with chronic HCV infection reported a wide variety of rheumatological manifestations, impairing their quality of life, with discrete frequency. These results suggest that HCV infection should be considered in the differential diagnosis of rheumatological symptoms of unknown origin.

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Mixed cryoglobulinaemia associated with hepatitis C virus infection: A predictor factor for treatment with interferon?

Abstract: The presence of cryoglobulinaemia does not influence the response to alpha-IFN in patients with chronic HCV infection.

Cited by 14 publications

References 17 publications

Cryoglobulinemia in chronic hepatitis C: clinical aspects and response to treatment with interferon alpha and ribavirin

Cryoglobulinemia in chronic hepatitis C: clinical aspects and response to treatment with interferon alpha and ribavirin

Biologic Immunomodulatory Therapies in the Vasculitic Diseases

Mixed cryoglobulinaemia and chronic hepatitis C virus infection: The rheumatic manifestations

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