Next Article in Journal / Special Issue
Hepatoma-Derived Growth Factor: Its Possible Involvement in the Progression of Hepatocellular Carcinoma
Previous Article in Journal
Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?
Previous Article in Special Issue
Association of preS/S Mutations with Occult Hepatitis B Virus (HBV) Infection in South Korea: Transmission Potential of Distinct Occult HBV Variants
Case Report

Successful and Safe Long-Term Standard Antiviral Therapy in a Patient with “Explosive” Immune Response in Course of HCV-Related Liver Cirrhosis

1
Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, 80131 Naples, Italy
2
Haematology Unit, Federico II University Medical School of Naples, 80131 Naples, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Tatsuo Kanda
Int. J. Mol. Sci. 2015, 16(6), 14075-14085; https://0-doi-org.brum.beds.ac.uk/10.3390/ijms160614075
Received: 22 April 2015 / Revised: 10 June 2015 / Accepted: 12 June 2015 / Published: 19 June 2015
(This article belongs to the Special Issue Viral Hepatitis Research)
Hepatitis C virus (HCV) has been recognized to be both a hepato- and lymphotropic virus. HCV lymphotropism represents an essential detail in the pathogenesis of virus-related autoimmune and lymphoproliferative disorders, ranging from clonal expansion of B-cells with organ and non-organ-specific autoantibody production up to overt non-Hodgkin’s lymphoma along a continuous step-by-step model of B-cell lymphomagenesis, where the intermediated mixed cryoglobulinemia could be considered as a stage of suppressible antigen-driven lymphoproliferation. The HCV long-lasting extrahepatic replicative state generates an abnormal systemic immunological response, including rheumatoid factor (RF) and cryo- and non-cryoprecipitable immune complexes, as well as clinical manifestations, comprising dermatitis, polyarthralgias and arthritis, pulmonary disease, aplastic anemia, glomerulonephritis and vasculitis. The mechanism of these extra-hepatic disorders is thought of as linked to immune complex disease, but their pathogenesis is poorly clarified. Immune-suppressive treatment could induce high-level hepatitis C viremia and impair hepatic disease. We report a female patient, whose chronic HCV-related liver cirrhosis with associated explosive, but oligosymptomatic lymphoproliferative immune response, i.e., RF beyond three thousand times the upper of normal range (unr), type II cryoglobulinemia with cryocrit 40% and monoclonal gammopathy IgM-k, has been successfully and safely treated by long-lasting (sixty-six months) combined antiviral therapy (pegylated interferon alfa and ribavirin), at moderate and tapering dose regimen, prolonged for nearly 24 months after the first viral suppression. At the last follow-up (fifty-one months), the patient was showing very-long term antiviral response, progressive decline of secondary immune activation and absence of significant side-effects. Further research is required to fully verify the real impact on therapeutic choice/regimen. View Full-Text
Keywords: hepatitis C infection; lymphoproliferative disorders; cryoblobulins; rheumatoid factor; antiviral treatment hepatitis C infection; lymphoproliferative disorders; cryoblobulins; rheumatoid factor; antiviral treatment
MDPI and ACS Style

Conca, P.; Cafaro, G.; De Renzo, A.; Coppola, A.; Cimino, E.; Tarantino, G. Successful and Safe Long-Term Standard Antiviral Therapy in a Patient with “Explosive” Immune Response in Course of HCV-Related Liver Cirrhosis. Int. J. Mol. Sci. 2015, 16, 14075-14085. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms160614075

AMA Style

Conca P, Cafaro G, De Renzo A, Coppola A, Cimino E, Tarantino G. Successful and Safe Long-Term Standard Antiviral Therapy in a Patient with “Explosive” Immune Response in Course of HCV-Related Liver Cirrhosis. International Journal of Molecular Sciences. 2015; 16(6):14075-14085. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms160614075

Chicago/Turabian Style

Conca, Paolo, Giovanni Cafaro, Amalia De Renzo, Antonio Coppola, Ernesto Cimino, and Giovanni Tarantino. 2015. "Successful and Safe Long-Term Standard Antiviral Therapy in a Patient with “Explosive” Immune Response in Course of HCV-Related Liver Cirrhosis" International Journal of Molecular Sciences 16, no. 6: 14075-14085. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms160614075

Find Other Styles

Article Access Map by Country/Region

1
Only visits after 24 November 2015 are recorded.
Back to TopTop