Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure
Treatment with a direct acting antiviral (DAA) has revolutionized HCV therapy, as more than 95% of patients achieve a sustained virological response (SVR). Cryoglobulinemic vasculitis (CryoVas), however, can persist and recur after the HCV cure. In this systematic review, we include data from 19 stu...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/4/984 |
| _version_ | 1797479133404463104 |
|---|---|
| author | Mahmood Danishwar Zahid Jamil Salman Khan Michael Nakhla Ishtiaq Ahmad Muhammad Ashar Ali Daryl T. Y. Lau |
| author_facet | Mahmood Danishwar Zahid Jamil Salman Khan Michael Nakhla Ishtiaq Ahmad Muhammad Ashar Ali Daryl T. Y. Lau |
| author_sort | Mahmood Danishwar |
| collection | DOAJ |
| description | Treatment with a direct acting antiviral (DAA) has revolutionized HCV therapy, as more than 95% of patients achieve a sustained virological response (SVR). Cryoglobulinemic vasculitis (CryoVas), however, can persist and recur after the HCV cure. In this systematic review, we include data from 19 studies that provided information on the persistence and recurrence of CryoVas after the HCV cure with DAAs. A complete clinical response (CR) was reported in 63.7% to 90.2% of the DAA-treated patients after achieving SVR. Relapse of CryoVas symptoms was reported in 4% to 18% of the patients. Neuropathy, nephropathy, and dermatological complications were the most common manifestations of CryoVas. B-cell clones persisted in 31–40% of the patients and could contribute to CryoVas relapse. INFL3-rs12979860, ARNTL-rs648122, RETN-rs1423096, and SERPINE1-rs6976053 were associated with a higher incidence of persistence and recurrence of CryoVas. Prospective multicenter studies with diverse patient populations are needed to validate these findings for the timely and effective management of this challenging condition. |
| first_indexed | 2024-03-09T21:41:38Z |
| format | Article |
| id | doaj.art-b221440b8d934d60aaf01bdc2b71a995 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:41:38Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b221440b8d934d60aaf01bdc2b71a9952023-11-23T20:29:55ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-0111498410.3390/jcm11040984Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV CureMahmood Danishwar0Zahid Jamil1Salman Khan2Michael Nakhla3Ishtiaq Ahmad4Muhammad Ashar Ali5Daryl T. Y. Lau6Liver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USALiver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USALiver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USALiver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USALiver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USALiver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USALiver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA 02115, USATreatment with a direct acting antiviral (DAA) has revolutionized HCV therapy, as more than 95% of patients achieve a sustained virological response (SVR). Cryoglobulinemic vasculitis (CryoVas), however, can persist and recur after the HCV cure. In this systematic review, we include data from 19 studies that provided information on the persistence and recurrence of CryoVas after the HCV cure with DAAs. A complete clinical response (CR) was reported in 63.7% to 90.2% of the DAA-treated patients after achieving SVR. Relapse of CryoVas symptoms was reported in 4% to 18% of the patients. Neuropathy, nephropathy, and dermatological complications were the most common manifestations of CryoVas. B-cell clones persisted in 31–40% of the patients and could contribute to CryoVas relapse. INFL3-rs12979860, ARNTL-rs648122, RETN-rs1423096, and SERPINE1-rs6976053 were associated with a higher incidence of persistence and recurrence of CryoVas. Prospective multicenter studies with diverse patient populations are needed to validate these findings for the timely and effective management of this challenging condition.https://www.mdpi.com/2077-0383/11/4/984cryoglobulinemic vasculitisDAA therapycryoglobulinemiahepatitis C |
| spellingShingle | Mahmood Danishwar Zahid Jamil Salman Khan Michael Nakhla Ishtiaq Ahmad Muhammad Ashar Ali Daryl T. Y. Lau Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure Journal of Clinical Medicine cryoglobulinemic vasculitis DAA therapy cryoglobulinemia hepatitis C |
| title | Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure |
| title_full | Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure |
| title_fullStr | Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure |
| title_full_unstemmed | Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure |
| title_short | Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure |
| title_sort | persistence of cryoglobulinemic vasculitis after daa induced hcv cure |
| topic | cryoglobulinemic vasculitis DAA therapy cryoglobulinemia hepatitis C |
| url | https://www.mdpi.com/2077-0383/11/4/984 |
| work_keys_str_mv | AT mahmooddanishwar persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure AT zahidjamil persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure AT salmankhan persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure AT michaelnakhla persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure AT ishtiaqahmad persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure AT muhammadasharali persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure AT daryltylau persistenceofcryoglobulinemicvasculitisafterdaainducedhcvcure |