TY - JOUR
T1 - Hepatitis B virus related cryoglobulinemic vasculitis
T2 - A multicentre open label study from the Gruppo Italiano di Studio delle Crioglobulinemie - GISC
AU - Mazzaro, Cesare
AU - Dal Maso, Luigino
AU - Urraro, Teresa
AU - Mauro, Endri
AU - Castelnovo, Laura
AU - Casarin, Pietro
AU - Monti, Giuseppe
AU - Gattei, Valter
AU - Zignego, Anna Linda
AU - Pozzato, Gabriele
PY - 2016
Y1 - 2016
N2 - Background: Cryoglobulinemic vasculitis (CV) related to Hepatitis-B Virus (HBV) is rare and its treatment is ill-defined. Aims: To describe clinical and treatment characteristics of HBV-related CV patients. In addition, the efficacy of treatment with antiviral agent nucleotide (NUC), including Entecavir, Adefovir, and Lamivudine, was explored. Methods: In four Italian centres, 17 HBV-positive CV patients (median age 56 years, range 45-70) were enrolled. Results: The extrahepatic manifestations were: purpura (100%), arthralgias (71%), peripheral neuropathy (29%), chronic hepatitis (47%), liver cirrhosis (29%), and glomerulonephritis (18%). Mixed cryoglobulinemias were type II (88%) and type III (12%). The median cryocrit was 3% (range 1-14), rheumatoid factor was 200. U/L (range 20-5850), C4 was 12. mg/dl (range 2-31), ALT 71. U/L (range 36-114). All patients were HBsAg-positive and 80% anti-HbeAg-positive. At enrollment, they were treated with steroids (eight), Entecavir (five), Alpha-IFN (two), Adefovir and Lamivudine (one each). After NUC treatment, no disease progression was observed and, in all patients, HBV-DNA became undetectable. Moreover, a regression of purpura and a reduction of cryocrit were observed. Four patients died during therapy, two of kidney failure and two of liver cirrhosis. Conclusion: NUC therapy appeared to be safe and effective in CV-related HBV.
AB - Background: Cryoglobulinemic vasculitis (CV) related to Hepatitis-B Virus (HBV) is rare and its treatment is ill-defined. Aims: To describe clinical and treatment characteristics of HBV-related CV patients. In addition, the efficacy of treatment with antiviral agent nucleotide (NUC), including Entecavir, Adefovir, and Lamivudine, was explored. Methods: In four Italian centres, 17 HBV-positive CV patients (median age 56 years, range 45-70) were enrolled. Results: The extrahepatic manifestations were: purpura (100%), arthralgias (71%), peripheral neuropathy (29%), chronic hepatitis (47%), liver cirrhosis (29%), and glomerulonephritis (18%). Mixed cryoglobulinemias were type II (88%) and type III (12%). The median cryocrit was 3% (range 1-14), rheumatoid factor was 200. U/L (range 20-5850), C4 was 12. mg/dl (range 2-31), ALT 71. U/L (range 36-114). All patients were HBsAg-positive and 80% anti-HbeAg-positive. At enrollment, they were treated with steroids (eight), Entecavir (five), Alpha-IFN (two), Adefovir and Lamivudine (one each). After NUC treatment, no disease progression was observed and, in all patients, HBV-DNA became undetectable. Moreover, a regression of purpura and a reduction of cryocrit were observed. Four patients died during therapy, two of kidney failure and two of liver cirrhosis. Conclusion: NUC therapy appeared to be safe and effective in CV-related HBV.
KW - Cryoglobulinemia
KW - Entecavir
KW - Hepatitis B virus
KW - Vasculitis
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U2 - 10.1016/j.dld.2016.03.018
DO - 10.1016/j.dld.2016.03.018
M3 - Article
AN - SCOPUS:84963805276
SP - 780
EP - 784
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
ER -