What are the Long-term Effects of DAA Therapy on HCV-associated Cryoglobulinemia Vasculitis?

What are the Long-term Effects of DAA Therapy on HCV-associated Cryoglobulinemia Vasculitis?

Dr. Kristine Novak

More than 95% of patients with hepatitis C virus–associated cryoglobulinemia vasculitis (HCV-CryoVas) have a full or partial response of symptoms to treatment with direct-acting antiviral (DAA) agents, researchers report in a long-term follow-up study in the February issue of Clinical Gastroenterology and Hepatology. Fewer than 5% of patients stopped therapy prematurely and fewer than 3% died. A severe form of CryoVas and peripheral neuropathy were associated with a lack of response of CryoVas to DAA therapy.

CryoVas is an immune complex–mediated systemic vasculitis that affects mainly small- and medium-sized vessels—it is observed in approximately 15% of patients with HCV infection and has an estimated 5-year mortality rate of 25%. Outcomes of patients with HCV-CryoVas associate with level of liver fibrosis and vasculitis of the kidney, central nervous system, heart, and digestive tract. Remission of vasculitis is associated with reponse to DAA therapy; a complete clinical response was reported in 90.2% of patients with HCV-CryoVas. 

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