Direct Antiviral Agents for Hepatitis C Virus-associated Cryoglobulinaemia Vasculitis
Status:
Unknown status
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
Cryoglobulinemia are responsible for systemic vasculitis, and the most frequently targeted
organs are the skin, joints, kidney and peripheral nervous system. Cryoglobulinemia
vasculitides are associated with significant morbidity and mortality, and require therapeutic
intervention. With the discovery of hepatitis C virus (HCV) as the etiologic agent for most
cases of mixed cryoglobulinemia new opportunities and problems for crafting therapy of HCV
mixed cryoglobulinemia (MC) have emerged. A new and major concern was the potential adverse
effects that immunosuppressive therapy with glucocorticoids and cytotoxic drugs could have on
an underlying chronic viral infection. Alternatively the discovery of HCV provided the
opportunity to control HCV-MC with antiviral therapy based on the belief that the underlying
infection was driving immune complex formation and resultant vasculitis. Inducing a sustained
virologic and clinical response and minimizing the use of immunosuppressive drugs are the
main goals in the treatment of patients with HCV-MC vasculitis. Aggressive antiviral therapy
has been shown to induce a complete remission of HCV-MC in up to 70% of patients. New
antiviral combination, Interferon (IFN)-free regimens have recently proved very high
virological response rate and with a very good safety profile and now need to be evaluated in
severe and/or refractory HCV-MC patient's population.