AB1150 Effect of Interferon Alpha Therapy on Chronic Hepatitis C Patients with Croglobulinaemia (Clinical &amp; Laboratory):
Authors: N. Mohannad, R. Kader
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Hepatitis C is a disease with significant global impact.Extrahepatic manifestations (EHM) are frequently noted in HCV patients (pts). Cryoglobulinemia can be detected in 25 to 30% of the pts &amp; is one of the most common disorders associated with HCV with a wide spectrum from mild purpura to life-threatening vasculitis.The most effective treatment (Rx) of symptomatic HCV MC is eradication of HCV infection. <h3>Objectives</h3> To study the impact of interferon alpha (IFN-α) therapy on clinical and laboratory parameters in pts with HCV infection with &amp; without cryoglobulin (CG) <h3>Methods</h3> EHM &amp; manifestations of CG as purpura, arthralgia, fatigue, renal,nor neurological complications were detected &amp; registered during the first &amp; follow-up visits. CBC, kidney functions, as well as the followings before &amp; after IFN-α therapy: liver functions (PT/INR, AST, ALT, s. albumin, total proteins, s. bilirubin) ESR, RF, quantitative PCR for HCV, s. CG, C4.The study included 100 HCV pts treated with peg-IFN plus ribavirin for 12 weeks regardless HCV genotype. Pts with other possible cause of CG were excluded <h3>Results</h3> Mean pts age:37.05±5.28 ys, mean disease duration 10.8±2.5 ys.The followings were observed: High prevalence of CG in chronic HCV pts (45% of patients). After Rx 13 CG +ve pts became -ve. (Complete responders (CR): HCV RNA became undetectable at the end of 12th week).Unlike the partial responders (PR), there was statistical significant difference in CG before and after Rx in CR (&lt;0.001*), the median CG decreased from 99 to 52 pg/ml &amp; the mean of C4 increased in CR (P&lt;0.001*). There was statistical significant difference between RF &amp; ESR before and after Rx in CR and PR P&lt;0.001* &amp; 0.020*. There was +ve correlation between CG level &amp; duration of infection, ALT, viral load and RF and a -ve one between CG &amp; albumin levels, total proteins and C4. &lt;0.001. Symptoms of mixed cryglobulinemia were present in both CG +ve and -ve pts except PN &amp; nephropathy which occurred only in CG+ve pts (table). There was statistical significant difference between purpura, fatigue, arthralgia, arthritis and myalgia with RF (P&lt;0.05), &amp; none between PN &amp; nephropathy and RF (P&gt;0.05). IFN plus ribavirin were very effective in decreasing the viral load, improving liver functions, decreasing CG, RF, ESR &amp; increasing C4 in CR more than PR. They were effective in the improvement of all CG symptoms except PN, nephropathy &amp; fatigue. <h3>Conclusions</h3> CG testing has been neglected in routine clinical laboratory by clinicians Patients with manifestations suggestive of cryoglobulinemia should be tested for hepatitis C and conversely, signs and symptoms of this condition should be screened in patients with known HCV infection. <h3>References</h3> Ferri C, et al.: Current treatment of hepatitis C-associated rheumatic diseases. Arthritis Res Ther 2012; 14:215. <h3>Disclosure of Interest</h3> None declared