抗病毒疗法对于初治的慢性丙型肝炎合并无症状的混和性冷沉淀球蛋白血症患者的疗效:一项初步研究

作     者：D'Amico E. Chincoli C. Cacciatore P. 李宏宇 

作者机构：Viale Alcione 249/B 66023 Francavilla al Mare (Ch) Italy Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第5期

页      面：13-14页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100214[医学-肿瘤学] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：球蛋白血症 慢性丙型肝炎 抗病毒疗法 丙肝患者 无症状性 冷沉淀 疗效 初治 步研究 抗病毒治疗 

摘      要：The clinical spectrum of mixed cryoglobulinemia embraces several manifestations: recurrent vascular purpura, weakness, arthralgia/arthritis, glomerulonephritis, peripheral neuropathies, and Raynaud’ s phenomenon. Mixed cryoglobulinemia is currently treated with steroids, low-antigencontent diet, immunosuppressors, plasma exchange, and antiviral therapy, namely, α -interferon alone or, more recently, in association with ribavirin. In the present research, we verified the effectiveness of combined therapy with interferon and ribavirin on asymptomatic mixed cryoglobulinemia in na ve (never treated before) patients with chronic hepatitis C. We enrolled 50 consecutive patients, 31 males and 19 females, with chronic hepatitis C who showed a sustained response to combined antiviral therapy (interferon and ribavirin). Before treatment, cryoglobulins were detected in 25 subjects (50% ). Only 1 of the 25 patients with asymptomatic mixed cryoglobulinemia had persistence of cryoglobulins at the end of the follow-up period. Unexpectedly, in 7 of 25 subjects without mixed cryoglobulinemia before treatment, cryoglobulins became detectable after antiviral therapy. Our present study first reports the onset of asymptomatic mixed cryoglobulinemia in hepatitis C virus patients after clearance of the virus from blood obtained with a combined antiviral treatment. Possible explanations are discussed. Our data also suggest that the appearance of a clinically evidentmixed cryoglobulinemia cannot be excluded in this kind of subject.