Combined Treatment with Antiviral Therapy and Rituximab in Patients with Mixed Cryoglobulinemia: Review of the Literature and Report of a Case Using Direct Antiviral Agents-Based Antihepatitis C Virus Therapy

Teresa Urraro; Laura Gragnani; Alessia Piluso; Alessio Fabbrizzi; Monica Monti; Elisa Fognani; Barbara Boldrini; Jessica Ranieri; Anna Linda Zignego

doi:10.1155/2015/816424

Case Reports in Immunology (Jan 2015)

Combined Treatment with Antiviral Therapy and Rituximab in Patients with Mixed Cryoglobulinemia: Review of the Literature and Report of a Case Using Direct Antiviral Agents-Based Antihepatitis C Virus Therapy

Teresa Urraro,
Laura Gragnani,
Alessia Piluso,
Alessio Fabbrizzi,
Monica Monti,
Elisa Fognani,
Barbara Boldrini,
Jessica Ranieri,
Anna Linda Zignego

Affiliations

Teresa Urraro: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Laura Gragnani: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Alessia Piluso: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Alessio Fabbrizzi: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Monica Monti: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Elisa Fognani: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Barbara Boldrini: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Jessica Ranieri: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy
Anna Linda Zignego: Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy

DOI: https://doi.org/10.1155/2015/816424
Journal volume & issue: Vol. 2015

Abstract

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Mixed cryoglobulinemia (MC) is an autoimmune/B-cell lymphoproliferative disorder associated with Hepatitis C Virus (HCV) infection, manifesting as a systemic vasculitis. In the last decade, antiviral treatment (AT) with pegylated interferon (Peg-IFN) plus ribavirin (RBV) was considered the first therapeutic option for HCV-MC. In MC patients ineligible or not responsive to antivirals, the anti-CD20 monoclonal antibody rituximab (RTX) is effective. A combined AT plus RTX was also suggested. Since the introduction of direct acting antivirals (DAAs), few data were published about MC and no data about a combined schedule. Here, we report a complete remission of MC after a sustained virological response following a combined RTX/Peg-IFN+RBV+DAA (boceprevir) treatment and review the literature about the combined RTX/AT.

Published in Case Reports in Immunology

ISSN: 2090-6609 (Print); 2090-6617 (Online)
Publisher: Wiley
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://onlinelibrary.wiley.com/journal/1615

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