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Treatment with direct-acting antivirals not only cures people of hepatitis C, but can also rapidly reduce the severity of one of the most troublesome extrahepatic manifestations of the disease, a study published this month shows.
Although studies of direct-acting antivirals show that newly-licensed combinations can cure hepatitis C in 90 to 95% of people, there is less information about the extent to which curing hepatitis C leads to improvements in the health of the liver or resolution of symptoms such as cryoglobulinemia.
Cryoglobulinemia is the presence of complexes of abnormal antibodies and proteins, which cluster in the blood vessels, in the kidneys or joints (vasculitis) causing skin lesions (purpura), pain in the joints of the hands and legs and damage to peripheral nerves (peripheral neuropathy). The presence of mixed cryoglobulins in the kidneys can lead to inflammation and kidney damage (glomerular nephritis) and the loss of kidney function over time.
Mixed cryoglobulinemia may be detected in up to half of people with hepatitis C, but in most people the condition does not cause symptoms. About one in twenty people with hepatitis C develop symptoms. There is some evidence that cryoglobulinemia increases the risk of developing cirrhosis.
Symptomatic disease as a result of cryoglobulinemia – especially kidney disease – is considered a reason to take hepatitis C treatment, regardless of the extent of liver damage. In the past, responses to treatment with pegylated interferon and ribavirin have been poor with a high rate of adverse events. Researchers from Massachusetts General Hospital and Brigham and Women’s Hospital, Boston, have now reported the first case series of 12 people with symptomatic cryoglobulinemia treated with direct-acting antivirals.
Read more..http://www.aidsmap.com/Direct-acting-antivirals-reduce-cryoglobulinemia-in-hepatitis-C/page/3036166/