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Review

Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos(t)ide Analogues from the Italian Study Group of Cryoglobulinemia (GISC)

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Clinical Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico (CRO) IRCCS, 33081 Aviano, Italy
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Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO) IRCCS, 33081 Aviano, Italy
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MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, 50121 Firenze, Italy
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Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
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Rheumatology Unit, Internal Medicine Unit, Presidio Ospedaliero di Saronno, ASST della Valle Olona, 21047 Saronno, Italy
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Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
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Division of Internal Medicine, Department of Medical and Surgical Sciences, Maternal-Infantile and Adult, University of Modena and Reggio Emilia, 41124 Modena, Italy
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Infectious Diseases, L. Sacco Hospital, Department of Biochemical and Clinical Sciences, University of Milan, 20157 Milan, Italy
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Rheumatology Clinic, Department of Medicine (DAME), ASUFC, University of Udine, 33100 Udine, Italy
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Authors to whom correspondence should be addressed.
Academic Editor: Curt Hagedorn
Received: 27 March 2021 / Revised: 5 May 2021 / Accepted: 26 May 2021 / Published: 30 May 2021
(This article belongs to the Special Issue Viral Hepatitis Treatment)
Hepatitis B virus (HBV) chronic infection causes progressive liver damage, although about 20% of patients develop extrahepatic manifestations such as cryoglobulinemic vasculitis (CV). Clinical manifestations range from mild to moderate (purpura, asthenia, arthralgia) to severe (leg ulcers, peripheral neuropathy, glomerulonephritis, non-Hodgkin lymphoma). A comprehensive review of therapeutic options for HBV-related CV is lacking. Nucleos(t)ide analogues (NA) suppress HBV replication in 90–100% of cases and induce clinical response in most patients with mild-to-moderate CV. Plasma exchange can be performed in patients with severe CV and should be considered in severe or life-threatening cases combined with high doses of corticosteroids and antiviral treatment. A cautious use of rituximab can be considered only in association with NA treatment in refractory cases. A review of the literature and an analysis of data collected by six centers of the Italian Group for the Study of Cryoglobulinemia on 18 HBV-CV nucleotide/nucleoside analogues (NAs)-treated patients were carried out. View Full-Text
Keywords: cryoglobulinemia; vasculitis; hepatitis B virus; entecavir; tenofovir cryoglobulinemia; vasculitis; hepatitis B virus; entecavir; tenofovir
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MDPI and ACS Style

Mazzaro, C.; Maso, L.D.; Gragnani, L.; Visentini, M.; Saccardo, F.; Filippini, D.; Andreone, P.; Zignego, A.L.; Gattei, V.; Monti, G.; Galli, M.; Quartuccio, L. Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos(t)ide Analogues from the Italian Study Group of Cryoglobulinemia (GISC). Viruses 2021, 13, 1032. https://0-doi-org.brum.beds.ac.uk/10.3390/v13061032

AMA Style

Mazzaro C, Maso LD, Gragnani L, Visentini M, Saccardo F, Filippini D, Andreone P, Zignego AL, Gattei V, Monti G, Galli M, Quartuccio L. Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos(t)ide Analogues from the Italian Study Group of Cryoglobulinemia (GISC). Viruses. 2021; 13(6):1032. https://0-doi-org.brum.beds.ac.uk/10.3390/v13061032

Chicago/Turabian Style

Mazzaro, Cesare, Luigino D. Maso, Laura Gragnani, Marcella Visentini, Francesco Saccardo, Davide Filippini, Pietro Andreone, Anna L. Zignego, Valter Gattei, Giuseppe Monti, Massimo Galli, and Luca Quartuccio. 2021. "Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos(t)ide Analogues from the Italian Study Group of Cryoglobulinemia (GISC)" Viruses 13, no. 6: 1032. https://0-doi-org.brum.beds.ac.uk/10.3390/v13061032

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