Persistence of Cryoglobulinemia in Patients with Chronic Hepatitis C after Successful Treatment with Direct-acting Antivirals

DOI 機関リポジトリ Web Site 参考文献33件 オープンアクセス
  • NAKAJIMA Yoko
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • UCHIKOSHI Manabu
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • WANG Tianpeng
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • SUGIURA Ikuya
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • KAJIWARA Atsushi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • ARAI Jun
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • UOZUMI Shojiro
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • SHIMOZUMA Yuu
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • SAKAKI Masashi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • NOMURA Norihiro
    Digestive Diseases Center, Showa University Koto Toyosu Hospital
  • EGUCHI Junichi
    Digestive Diseases Center, Showa University Koto Toyosu Hospital
  • NOZAWA Hisako
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • KURIHARA Toshikazu
    Department of Medicine, Division of Internal Medicine, Showa University Karasuyama Hospital
  • ITO Takayoshi
    Digestive Diseases Center, Showa University Koto Toyosu Hospital
  • YOSHIDA Hitoshi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine

書誌事項

公開日
2019
資源種別
departmental bulletin paper
DOI
  • 10.15369/sujms.31.253
公開者
昭和大学学士会

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説明

Hepatitis C virus（HCV）infection can cause chronic liver disease; it has also been associated with lymphoproliferative disorders（LPDs）, such as cryoglobulinemia and B-cell non-Hodgkin’s lymphoma. Our previous studies suggested that cryoglobulinemia, high titer of rheumatoid factor（RF）, and hypocomplementemia are immunological markers of LPDs. In addition, recent therapies with direct-acting antivirals（DAAs）have achieved high rates of sustained virological response（SVR）in patients with chronic hepatitis C（CH-C）. This study analyzed the efficacy of DAA therapy in CH-C patients with cryoglobulinemia, and the association of biochemical and other immune markers for LPDs with persistence of cryoglobulinemia in patients after DAA therapy. Of 226 patients tested, 31（13.7％）had cryoglobulinemia prior to receiving DAAs, and these individuals showed lower complement 4 levels, decreased complement hemolytic activity, and higher IgM than patients without cryoglobulinemia. Of the 24 cryoglobulinemia-positive patients（83％）who could be followed for 24 weeks, 20 became cryoglobulinemia negative after the therapy. The remaining four patients retained the abnormal LPD markers, indicating the possibility of long-term LPD persistence even following successful eradication of HCV in CH-C patients. Thus, long-term follow-up is recommended to avoid exacerbation of extrahepatic manifestations as well as new events.

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