Successful Treatment Using Simeprevir, Sofosbuvir and Rituximab of a Severe Form of Hepatitis C Virus-related Mixed Cryoglobulinemia with Cardiac Involvement
  • Rafael Mahieu
    Department of Infectious Diseases, Angers University Hospital
  • Christian Lavigne
    Department of Internal Medicine, Angers University Hospital
  • Geoffrey Urbanski
    Department of Internal Medicine, Angers University Hospital
  • Isabelle Fouchard Hubert
    Department of Hepatology, Angers University Hospital
  • Alexandra Ducancelle
    Department of Biology of Infectious agents, Angers University Hospital; Laboratory HIFIH UPRES EA 3859 Medical University of Angers
  • Françoise Lunel-Fabiani
    Department of Biology of Infectious agents, Angers University Hospital; Laboratory HIFIH UPRES EA 3859 Medical University of Angers

Keywords

Mixed cryoglobulinemia, hepatitis C virus, sofosbuvir, simeprevir

Abstract

Numerous extrahepatic manifestations have been reported in hepatitis C virus (HCV) infection, particularly mixed cryoglobulinemia (MC). MC generally responds to clearance of HCV under pegylated-interferon plus ribavirin treatment. New direct-acting antiviral agents have been licensed for HCV under different combinations but have not been studied in severe forms of MC. Here, we present a case report describing a life-threatening form of MC with multivisceral involvement, which was successfully treated with concomitant rituximab, sofosbuvir and simeprevir. In light of the rapid clinical remission associated with sustained virological response and the excellent side-effect profile, this treatment should be considered as a first-line therapy in severe forms of MC.

VIEW THE ENTIRE ARTICLE

References

  • Lunel F, Musset L, Cacoub P, Frangeul L, Cresta P, Perrin M, et al. Cryoglobulinemia in chronic liver diseases: role of hepatitis C virus and liver damage. Gastroenterology 1994;106:1291–1300.
  • Terrier B, Karras A, Cluzel P, Collet J-P, Sène D, Saadoun D, et al. Presentation and prognosis of cardiac involvement in hepatitis C virus-related vasculitis. Am J Cardiol 2013;111:265–272.
  • De Vita S, Quartuccio L, Isola M, Mazzaro C, Scaini P, Lenzi M, et al. A randomized controlled trial of rituximab for the treatment of severe cryoglobulinemic vasculitis. Arthritis Rheum 2012;64:843–853.
  • Saadoun D, Resche Rigon M, Pol S, Thibault V, Blanc F, Pialoux G, et al. PegIFNα/ribavirin/protease inhibitor combination in severe hepatitis C virus-associated mixed cryoglobulinemia vasculitis. J Hepatol 2015;62:24–30.
  • American Association for the Study of Liver Diseases. Recommendations for testing, managing, and treating hepatitis C. 2015. www.hcvguidelines.org/full-report-view.
  • Views: 941
    HTML downloads: 341
    PDF downloads: 344
    Table1 downloads: 0


    Published: 2015-11-11
    Issue: Vol. 2 No. 7 (2015) (view)


    How to cite:
    1.
    Mahieu R, Lavigne C, Urbanski G, Fouchard Hubert I, Ducancelle A, Lunel-Fabiani F. Successful Treatment Using Simeprevir, Sofosbuvir and Rituximab of a Severe Form of Hepatitis C Virus-related Mixed Cryoglobulinemia with Cardiac Involvement. EJCRIM 2015;2 doi:10.12890/2015_000299.