Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure

Mahmood Danishwar; Zahid Jamil; Salman Khan; Michael Nakhla; Ishtiaq Ahmad; Muhammad Ashar Ali; Daryl T. Y. Lau

doi:10.3390/jcm11040984

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Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure

Journal article

Open access

Peer reviewed

Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure

Mahmood Danishwar, Zahid Jamil, Salman Khan, Michael Nakhla, Ishtiaq Ahmad, Muhammad Ashar Ali and Daryl T. Y. Lau

Journal of clinical medicine, Vol.11(4), 984

02/14/2022

DOI: 10.3390/jcm11040984

PMCID: PMC8878349

PMID: 35207257

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Abstract

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.

General & Internal Medicine

Life Sciences & Biomedicine

Medicine, General & Internal

Science & Technology

Details

Title: Subtitle: Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure
Creators: Mahmood Danishwar - Beth Israel Deaconess Medical Center
Zahid Jamil - Beth Israel Deaconess Medical Center
Salman Khan
Michael Nakhla
Ishtiaq Ahmad
Muhammad Ashar Ali - Beth Israel Deaconess Medical Center
Daryl T. Y. Lau - Harvard University
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.11(4), 984
DOI: 10.3390/jcm11040984
PMID: 35207257
PMCID: PMC8878349
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Publisher: Mdpi
Number of pages: 13
Language: English
Date published: 02/14/2022
Academic Unit: Internal Medicine
Record Identifier: 9985088576702771

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