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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...

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Autores principales: Danishwar, Mahmood, Jamil, Zahid, Khan, Salman, Nakhla, Michael, Ahmad, Ishtiaq, Ali, Muhammad Ashar, Lau, Daryl T. Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878349/
https://www.ncbi.nlm.nih.gov/pubmed/35207257
http://dx.doi.org/10.3390/jcm11040984
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author Danishwar, Mahmood
Jamil, Zahid
Khan, Salman
Nakhla, Michael
Ahmad, Ishtiaq
Ali, Muhammad Ashar
Lau, Daryl T. Y.
author_facet Danishwar, Mahmood
Jamil, Zahid
Khan, Salman
Nakhla, Michael
Ahmad, Ishtiaq
Ali, Muhammad Ashar
Lau, Daryl T. Y.
author_sort Danishwar, Mahmood
collection PubMed
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.
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spelling pubmed-88783492022-02-26 Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure Danishwar, Mahmood Jamil, Zahid Khan, Salman Nakhla, Michael Ahmad, Ishtiaq Ali, Muhammad Ashar Lau, Daryl T. Y. J Clin Med Review 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. MDPI 2022-02-14 /pmc/articles/PMC8878349/ /pubmed/35207257 http://dx.doi.org/10.3390/jcm11040984 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Danishwar, Mahmood
Jamil, Zahid
Khan, Salman
Nakhla, Michael
Ahmad, Ishtiaq
Ali, Muhammad Ashar
Lau, Daryl T. Y.
Persistence of Cryoglobulinemic Vasculitis after DAA Induced HCV Cure
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 Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878349/
https://www.ncbi.nlm.nih.gov/pubmed/35207257
http://dx.doi.org/10.3390/jcm11040984
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