Improvement in Waldenström's Macroglobulinemia after Successful Treatment of HCV with Direct-acting Antivirals.

Abstract

Chronic hepatitis C (HCV) virus infection may be associated with several non-hepatic manifestations, mainly driven by chronic immune stimulation, such as mixed cryoglobulinemia and Non-Hodgkin's Lymphoma. This association has been proved by several meta-analyses and some interventional studies demonstrating that antiviral treatment may be effective in inducing HCV-associated lymphoma regression. The recent advent of direct acting antivirals (DAAs) in the therapeutic armamentarium of HCV infection made possible treatment of patients with advanced liver disease. Here we report on a rare association of a cirrhotic patient with HCV and Waldenström's Macroglobulinemia with severe cryoglobulinemia, who had already failed an interferon-based antiviral regimen, whose haematologic disease was ameliorated by HCV eradication following treatment with sofosbuvir and simeprevir with ribavirin, and where successful treatment was accompanied also by consistent improvement in liver function and parameters of portal hypertension.

• Authors: Mattia Crespi, Maria Giulia Demarzo, Matteo Brunacci, Gaia Pellegatta, Fabio Ferrando, Alberto Ballestrero, Federica Grillo, Vincenzo Savarino, Edoardo G Giannini
• Journal: Annals of hepatology (Ann Hepatol) Vol. 17 Issue 6 Pg. 1072-1077 (10 16 2018) ISSN: 1665-2681 [Print] Mexico
• PMID: 30600285 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antiviral Agents
• Simeprevir
• Sofosbuvir

Topics

• Antiviral Agents (therapeutic use)
• Biopsy, Needle
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Hepatitis C, Chronic (complications, drug therapy, pathology)
• Humans
• Immunohistochemistry
• Liver Cirrhosis (drug therapy, pathology, virology)
• Middle Aged
• Severity of Illness Index
• Simeprevir (therapeutic use)
• Sofosbuvir (therapeutic use)
• Treatment Outcome
• Waldenstrom Macroglobulinemia (complications, drug therapy, pathology)