Wednesday, March 16, 2011

Hepatitis C-related vasculitis

Outcomes Differ Among Hepatitis C-Related Vasculitides

Hepatitis C-related polyarteritis nodosa has more acute presentation, higher remission rate

WEDNESDAY, March 16 (HealthDay News) -- Among patients with hepatitis C virus (HCV)-related vasculitis, those with polyarteritis nodosa (PAN) have a more severe and acute clinical presentation and a higher rate of clinical remission, according to a study published online Feb. 25 in Arthritis Care & Research.

David Saadoun, M.D., Ph.D., of Groupe Hospitalier Pitié-Salpêtrière in Paris, and colleagues investigated the prevalence and characteristics of PAN in a cohort of 161 patients with chronic HCV-related vasculitis.

The features and outcomes of 31 patients with HCV-PAN were compared with those patients with HCV-associated mixed cryoglobulinemia (HCV-MC).

The researchers found that, compared to HCV-MC, a more severe and acute presentation was seen in patients with HCV-PAN. They had more frequent fever and weight loss, severe hypertension, involvement of the gastrointestinal tract, severe and acute multifocal neuropathy, kidney and liver microaneurysms, and elevated C-reactive protein. However, clinical remission occurred in 79.3 percent of those with HCV-PAN compared to 57.5 percent of those with HCV-MC. A complete clinical response of HCV vasculitis was independently correlated with skin involvement and PAN-type vasculitis; whereas, a glomerular filtration rate less than 70 mL per minute was negatively correlated with the clinical response. Among the entire HCV-related vasculitis cohort, the five-year survival rate was 86 percent, irrespective of the type of vasculitis.

"HCV-PAN accounts for 19.3 percent of our cohort of HCV-related vasculitis. HCV-PAN compared to HCV-MC displays a more severe and acute clinical presentation, a distinct pathogenic pathway, and a higher rate of clinical remission," the authors write.
One of the study authors disclosed financial ties with several pharmaceutical companies.

AbstractFull Text (subscription or payment may be required)

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