Antiviral therapy of chronic hepatitis C complicated by systemic cryoglobulinemic vasculitis
Abstract
Literature analysis of published data on mechanisms of infection, disease progression and treatment of chronic hepatitis C, associated with systemic cryoglobulinemic vasculitis and kidney involvement is presented. A clinical case of effective treatment of cryoglobulinemic vasculitis associated with HCV infection is described. Female with HCV infection genotype 1b with liver fibrosis 1 grade Metavir developed clinical picture of essential mixed cryoglobulinemia II type with monoclonal IgM/kappa production. Cryoglobulinemia was presented with skin hemorrhagic vasculitis, proliferative vasculitis of small liver vessels, kidney involvement with III type membranoproliferative glomerulonephritis. Treatment with Dasabuvir;Оmbitasvir+Paritaprevir+Ritonavir without immunosuppressive medications or steroids resulted in persistent virologic response by 12 weeks after administration and also dramatic reduction of cryoglobulimenia from 27% to 8%, suppression of detectable IgM/kappa production, diminished skin vasculitis, restoration of glomerular filtration rate, proteinuria and decrease in erythrocyteuria.
About the Authors
N. V. Dunaeva
Centers for AIDS and Other Infectious Diseases
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
V. E. Karev
Science Research Institute of Children’s Infections
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
O. A. Vorobyeva
National Center of Clinical Morphological Diagnostics
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
A. V. Mazing
First Saint-Petersburg State Medical University named after I.P. Pavlov
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
S. V. Lapin
First Saint-Petersburg State Medical University named after I.P. Pavlov
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
A. V. Smirnov
Novgorod State University named after Yaroslav-the-Wise
Russian Federation
Veliky Novgorod
Russian Federation
Veliky Novgorod
D. A. Gusev
Centers for AIDS and Other Infectious Diseases
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
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Review
For citations:
Dunaeva N.V., Karev V.E., Vorobyeva O.A., Mazing A.V., Lapin S.V., Smirnov A.V., Gusev D.A. Antiviral therapy of chronic hepatitis C complicated by systemic cryoglobulinemic vasculitis. Journal Infectology. 2016;8(2):40-47. (In Russ.)
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