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Longterm efficacy of interferon-alpha for extrahepatic disease associated with hepatitis C virus infection. 11/2001

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  • claudine intexas
    J Rheumatol 2001 Nov;28(11):2466-73 Longterm efficacy of interferon-alpha for extrahepatic disease associated with hepatitis C virus infection. Naarendorp M,
    Message 1 of 1 , Nov 27, 2001
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      J Rheumatol 2001 Nov;28(11):2466-73

      Longterm efficacy of interferon-alpha for extrahepatic
      disease associated with hepatitis C virus infection.

      Naarendorp M, Kallemuchikkal U, Nuovo GJ, Gorevic PD.

      Department of Pathology, Ohio State University School
      of Medicine, Columbus, USA.

      OBJECTIVE: To investigate longterm responsiveness to
      interferon-alpha (lFN-alpha) of patients with
      extrahepatic manifestations of hepatitis C virus (HCV)
      in a nonendemic area. METHODS: We prospectively
      evaluated 11 patients with extrahepatic manifestations
      of HCV infection, including 10 with Type II
      cryoglobulins, treated with IFN-alpha--9 had cutaneous
      vasculitis, 6 arthralgias, 7 neuropathy, and 4
      glomerulonephritis. Liver biopsies were performed on
      all patients, although 6/11 had normal liver function
      tests. All received 3 M units IFN-alpha tiw, with
      total length of treatment ranging from 3 mo to 5 yrs.
      Periodic assessments were made of clinical activity,
      biochemical variables, cryoglobulin quantitation, and
      HCV copy number. RESULTS: Three patients were
      withdrawn because of toxicity. Three were
      nonresponders at 6, 16, and 17 mo of therapy, based on
      persistence of HCV RNA in blood, cryoprecipitates, and
      peripheral blood mononuclear cells. One patient was a
      partial responder at 3 yrs, with 2 major flares of
      cutaneous vasculitis occurring on separate attempts to
      withdraw IFN-alpha. Three patients (27.2%) were
      complete responders based on resolution of symptoms
      (purpura, neuropathy) and disappearance of
      cryoprecipitates and HCV RNA, but only one
      successfully tapered IFN-alpha after 3 yrs of
      treatment, with sustained resolution at followup 15 mo
      later. CONCLUSION: IFN-alpha is safely tolerated for
      prolonged periods in patients with extrahepatic HCV
      infection, and is particularly effective for treatment
      of cutaneous vasculitis. Careful monitoring is needed
      for evolution of liver pathology to cirrhosis, or for
      progression of renal or neurologic disease.

      PMID: 11708420 [PubMed - in process

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