In a prospective cohort study, patients who experienced hepatitis C virus infection clearance after treatment with pegylated interferon and ribavirin also had improved mixed cryoglobulinemia, according to data published in Hepatology.
“The aim of this study was to prospectively analyze a large cohort of HCV patients with or without [mixed cryoglobulinemia], symptomatic or not, treated with pegylated interferon and ribavirin according to standard criteria, in order to evaluate whether the presence of [mixed cryoglobulinemia] influences the virological response and the long-term effects of sustained virological response on [mixed cryoglobulinemia syndrome],” the researchers wrote.
Researchers enrolled 424 patients (mean age 51.3 ± 12.6 years) with HCV of which 121 had mixed cryoglobulinemia syndrome (MCS-HCV), 132 had asymptomatic MC (MC-HCV) and 158 did not have MC. Each patient received pegylated interferon (PEG-IFN) alpha-2a or alpha-2b in combination with weight-based ribavirin. The mean post-treatment follow-up was 92.5 months and 411 patients were included in the final analyses.
Overall, 61.4% of patients with HCV alone achieved sustained virologic response (SVR), 45.5% of patients with MC-HCV, 52% of patients with MCS-HCV and 48.6% of patients with MC-HCV and MCS-HCV, according to the research. SVR rates were lower in patients with MC-HCV (P = .009) and MC-HCV and MCS-HCV (P = .014) compared with patients with just HCV.
Symptoms of MCS were undetectable in 57% of patients who reached SVR (n=36), and only 3% of patients who reached SVR experienced persistent MCS (n=2).
Multivariate analyses showed cryoglobulinemia to be an independent factor of nonresponse to PEG-IFN and ribavirin treatment.
“This study definitively confirms the key importance of viral eradication in allowing persistent resolution or consistent improvement of HCV-MCS, strongly suggesting the need for a next generation of highly effective antiviral drugs,” the researchers concluded. – by Melinda Stevens
Disclosure: Iannacone reports consulting for Roche. Please see the full study for a list of all other authors’ relevant financial disclosures.